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Health condition · Clinically reviewed

Brain tumours, from red flag symptoms and MRI to modern surgery, radiotherapy and targeted care.

Not one disease but many. A calm, UK focused guide to the main types of primary brain tumour, how they are diagnosed and how they are treated in 2026.

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A radiographer guides a patient onto the bed of an advanced 3 Tesla MRI scanner in a London imaging suite

Why trust this guide

  • 01

    Clinically reviewed

    Written by our editorial team and reviewed by a registered UK clinician before publication.

  • 02

    Sourced from guidance

    Checked against NICE, NHS England, the Royal College of Radiologists and peer reviewed neuro oncology sources.

  • 03

    Current for 2026

    Reflects the WHO CNS5 (2021) classification, IDH targeted therapy (vorasidenib), 5 ALA guided surgery and modern proton and stereotactic radiotherapy.

Key facts

Brain tumours at a glance.

The essentials, in plain English: what a brain tumour is, the main types, how it is diagnosed and how it is treated in the UK today.

  • What it is

    A brain tumour is any abnormal growth arising from cells of the brain, its coverings, cranial nerves or pituitary gland. Primary tumours start in the brain; metastases spread from elsewhere and are far more common in adults.

  • How common

    Around 12,000 primary brain and CNS tumours are diagnosed each year in the UK across all ages, with brain metastases many times more common in the adult cancer population.

  • Main types

    Gliomas (including glioblastoma), meningiomas, pituitary adenomas, vestibular schwannomas, medulloblastomas in children, and CNS lymphoma among others.

  • How it presents

    New or progressive headache with red flag features, a first seizure in an adult, focal weakness, speech or visual change, endocrine symptoms or personality change.

  • How it is diagnosed

    MRI brain with gadolinium is the imaging gold standard, with tissue biopsy and molecular profiling to complete the WHO CNS5 diagnosis.

  • How it is treated

    Neuro oncology MDT care combining maximum safe surgery, radiotherapy (external beam, stereotactic radiosurgery or proton), systemic therapy and supportive care.

Why this guide matters

Many diseases, one clear pathway.

Brain tumours range from slow growing meningiomas to aggressive glioblastomas. The three points below shape everything else on this page.

  • The type matters more than the label

    Glioma, meningioma, pituitary adenoma, vestibular schwannoma, medulloblastoma or metastasis: each is a different disease with its own outlook and treatment.

  • MRI and molecular profiling drive care

    MRI brain with gadolinium and WHO CNS5 molecular markers (IDH, MGMT, 1p/19q and others) are the backbone of a precise diagnosis.

  • Modern treatment is truly multimodal

    Surgery, focused radiotherapy (including stereotactic radiosurgery and protons), systemic therapy and rehabilitation are combined to protect both survival and quality of life.

Types

The main kinds of brain tumour.

A short tour of the tumours a UK neuro oncology MDT sees most often, from gliomas to pituitary lesions and paediatric medulloblastoma.

  • Gliomas

    Astrocytoma (grades 1 to 4), oligodendroglioma (IDH mutant, 1p/19q codeleted) and ependymoma. Glioblastoma (grade 4, IDH wildtype) is the most common malignant primary brain tumour in adults with a median survival around 15 months on the Stupp protocol.

  • Meningioma

    Arises from the meninges. WHO grade 1 (benign) is most common, with grade 2 (atypical) and grade 3 (anaplastic) requiring more intensive treatment. Management ranges from surveillance to surgery to radiotherapy.

  • Pituitary adenoma

    Functioning tumours cause prolactinoma, acromegaly, Cushing disease or TSH excess; non functioning tumours present with mass effect. Treatment combines transsphenoidal surgery, medication and selective radiotherapy.

  • Vestibular schwannoma

    Also called acoustic neuroma. Presents with asymmetric hearing loss, tinnitus and balance disturbance. Managed with observation, microsurgery or stereotactic radiosurgery depending on size and hearing.

  • Medulloblastoma

    The most common malignant paediatric brain tumour, arising in the posterior fossa. Molecularly grouped as WNT, SHH, Group 3 and Group 4, each with different treatment and outlook.

  • Other primary tumours

    Craniopharyngioma, haemangioblastoma (linked to von Hippel Lindau), germ cell tumours, primary CNS lymphoma and atypical teratoid rhabdoid tumour (ATRT) in young children.

  • Brain metastases

    Cancer spread from the lung, breast, melanoma, kidney or bowel. Far more common in adults than primary tumours and treated with surgery, stereotactic radiosurgery and systemic therapy.

  • WHO CNS5 classification

    Since 2021 the WHO classification integrates how the tumour looks under the microscope with molecular markers such as IDH, 1p/19q, ATRX, TERT and H3K27M to give a much more precise diagnosis.

  • UK incidence

    Around 12,000 primary brain and CNS tumours are diagnosed each year in the UK. Care is centralised at supraregional neuroscience centres, from Queen Square and King’s to Edinburgh and Glasgow.

How the diagnosis is made

From first symptoms to a clear MDT plan.

The steps a UK GP, neurologist or neurosurgeon will normally follow, in order, so you know what to expect and why.

  1. 01

    Recognising

    Recognising red flag symptoms

    A new or progressive headache with morning vomiting, a first adult seizure, focal weakness or personality change prompts urgent assessment.

  2. 02

    Recognising

    Urgent referral pathway

    Two week wait suspected cancer, first fit clinic or straight to test MRI, depending on the local pathway and presenting features.

  3. 03

    Recognising

    MRI brain with gadolinium

    The gold standard, often with advanced sequences (perfusion, spectroscopy, DTI and fMRI) to characterise the lesion and plan surgery.

  4. 04

    Confirming

    Whole spine MRI and staging

    Added for medulloblastoma, ependymoma or germ cell tumours where CSF and drop metastases must be excluded.

  5. 05

    Confirming

    Biopsy and molecular profiling

    Tissue is tested for IDH, MGMT methylation, 1p/19q codeletion, ATRX, TERT, EGFR, BRAF, H3K27M and MYCN to give a WHO CNS5 diagnosis.

  6. 06

    Confirming

    Endocrine and visual work up

    A pituitary hormonal profile and formal visual field testing where a sellar or suprasellar lesion is suspected.

  7. 07

    Planning

    Neuro oncology MDT plan

    A specialist team agrees the plan: surveillance, surgery, radiotherapy, systemic therapy or a combination, with rehab and supportive care built in.

Typical timeline: from red flag to MDT plan in days to a few weeks under an urgent pathway.

Symptoms

What a brain tumour can look like.

Not every headache is a tumour. But some patterns and combinations of symptoms deserve urgent imaging rather than reassurance.

  • Red flag headache

    New or progressively worse, worse in the morning, wakes you from sleep or comes with vomiting or new neurology.

  • First seizure in an adult

    A first seizure over the age of 16, and especially over 40, needs urgent brain imaging to exclude a structural cause.

  • Focal neurological deficit

    New weakness, numbness, speech disturbance, visual field loss or clumsiness that persists or progresses.

  • Endocrine and pituitary features

    Galactorrhoea, amenorrhoea, gynaecomastia, erectile dysfunction, acromegalic change, Cushingoid features or diabetes insipidus.

  • Visual disturbance

    Bitemporal hemianopia from chiasmal compression, cranial nerve palsies, diplopia or an upgaze palsy (Parinaud syndrome).

  • Cognitive and personality change

    A change in memory, mood, motivation or personality noticed by family, especially over weeks to a few months.

  • Balance and gait disturbance

    Unsteadiness, coordination difficulty or a posterior fossa gait, often with headache or vomiting.

  • Raised intracranial pressure

    Headache with vomiting, drowsiness, papilloedema or reduced consciousness needs same day emergency assessment.

Treatment

How brain tumours are treated in the UK.

Care is always MDT led, combining maximum safe surgery, focused radiotherapy, systemic therapy and rehabilitation. The mix depends on the tumour type, molecular profile and location.

  • Neuro oncology MDT

    Care is coordinated by a specialist multidisciplinary team at a supraregional centre, combining neurosurgery, oncology, radiology, pathology and clinical nurse specialists.

  • Maximum safe surgery

    Craniotomy with neuronavigation, intraoperative mapping, 5 ALA fluorescence (Gliolan) and intraoperative MRI to remove as much tumour as safely possible.

  • Awake craniotomy

    For tumours in eloquent regions the patient is woken during surgery so language and motor function can be mapped and preserved.

  • External beam radiotherapy

    Modern conformal or intensity modulated radiotherapy, planned on MRI, and given over several weeks after surgery for many higher grade tumours.

  • Stereotactic radiosurgery

    Gamma Knife or CyberKnife delivers a single or few high dose fractions to small, well defined targets such as vestibular schwannomas, meningiomas and brain metastases.

  • Proton beam therapy

    Preferred for many childhood tumours, skull base lesions and tumours close to critical structures, to reduce long term cognitive, endocrine and second cancer risk.

  • Temozolomide and Stupp

    The Stupp protocol combines radiotherapy with concurrent and adjuvant temozolomide, the standard first line systemic therapy for glioblastoma.

  • PCV chemotherapy

    Procarbazine, CCNU (lomustine) and vincristine, used with radiotherapy for many oligodendrogliomas and selected astrocytomas.

  • IDH targeted therapy

    Vorasidenib (Voranigo), an IDH1/2 inhibitor, is a practice changing option for residual or recurrent IDH mutant grade 2 astrocytoma and oligodendroglioma.

  • BRAF/MEK and other targeted

    Dabrafenib with trametinib for BRAF V600E mutant paediatric glioma, selumetinib for NF1 plexiform disease and everolimus for TSC associated SEGA.

  • Tumour treating fields

    Optune, a wearable device delivering alternating electric fields, is used with maintenance temozolomide in selected glioblastoma patients.

  • Bevacizumab

    An anti VEGF antibody used in recurrent glioblastoma to reduce oedema, control symptoms and, in some, prolong progression free survival.

  • Pituitary treatment

    Transsphenoidal endoscopic surgery, medical therapy (cabergoline or bromocriptine, somatostatin analogues, ketoconazole or metyrapone) and selective radiotherapy.

  • Vestibular schwannoma pathway

    Observation with serial MRI, microsurgical resection (retrosigmoid, translabyrinthine or middle fossa) or stereotactic radiosurgery, tailored to hearing and size.

  • Supportive care

    Dexamethasone for oedema, levetiracetam for seizure control, antiemetics, neurorehabilitation, neuropsychology, palliative care and a specialist nurse.

  • Practical support

    DVLA notification for driving, workplace and school liaison, and charity support from The Brain Tumour Charity, Brain Tumour Research and Brain & Spine Foundation.

What this guide is based on

The sources behind every claim on this page.

UK national guidance, WHO classification and specialist society standards, current at the time of last review.

Key references

Guidelines and standards we relied on.

A quiet reminder

This guide is for information, not medical advice.

Your neurologist, neurosurgeon or oncologist knows your imaging, pathology and history and can tell you which parts apply to you. If in doubt, get seen.

  • WHO Classification of Tumours of the Central Nervous System, 5th edition (WHO CNS5, 2021).

  • NICE. Brain tumours (primary) and brain metastases in adults (NG99).

  • NHS England. Service specification for neurosurgery and neuro oncology.

  • The Royal College of Radiologists. Guidance on stereotactic radiosurgery and proton beam therapy.

  • INDIGO trial (Mellinghoff et al., NEJM 2023) and MHRA approval of vorasidenib for IDH mutant glioma.

  • The Brain Tumour Charity, Brain Tumour Research and Brain & Spine Foundation patient resources.

Red flags

When brain symptoms need urgent attention.

Most headaches are not brain tumours. These are the situations where imaging or emergency assessment cannot wait.

  • Reduced consciousness

    Drowsiness, confusion or a fall in GCS with headache and vomiting suggests raised intracranial pressure and needs same day emergency care.

  • First seizure in an adult

    A first seizure over the age of 16 is a mandatory indication for urgent brain imaging to exclude a structural cause.

  • Rapidly progressive neurology

    New weakness, speech disturbance, visual field loss or ataxia progressing over days to weeks needs urgent specialist review.

  • Morning headache with vomiting

    Headaches that wake you from sleep or are worst in the morning, with vomiting, are a classic red flag for a mass lesion.

  • New personality or cognitive change

    A subacute change in memory, mood or personality noticed by family should prompt neurological assessment, not reassurance.

  • Bitemporal hemianopia

    Loss of both outer visual fields suggests chiasmal compression from a pituitary or suprasellar tumour and needs urgent MRI.

  • Asymmetric hearing loss and tinnitus

    Unilateral sensorineural hearing loss, tinnitus or imbalance can be the first sign of a vestibular schwannoma.

  • Endocrine crisis

    Symptoms of adrenal insufficiency, severe hyponatraemia or diabetes insipidus in a patient with a known pituitary lesion need emergency care.

  • Suspected brain metastases

    New neurological symptoms in someone with a known cancer should be treated as suspected metastases until imaging proves otherwise.

Living with it

A serious diagnosis, with a strong team around you.

Four things that make the biggest difference in the weeks and months after diagnosis: specialist care, early rehab, driving safety and support from the UK brain tumour charities.

A quiet reminder

You do not have to face this alone.

A clinical nurse specialist, a neuro rehab team and one of the UK charities can walk with you through diagnosis, treatment and life afterwards.

  1. 01 Team

    Stay under a specialist centre

    Care for a brain tumour should sit with a neuro oncology MDT at one of the UK supraregional centres, with a clinical nurse specialist as your first point of contact.

  2. 02 Rehab

    Use neurorehabilitation early

    Physiotherapy, occupational therapy, speech and language therapy and neuropsychology all help you recover function and adjust after surgery or radiotherapy.

  3. 03 Driving

    Tell the DVLA

    A brain tumour, a seizure or certain treatments require you to notify the DVLA. Your team will tell you when driving is allowed to resume.

  4. 04 Support

    Lean on the charities

    The Brain Tumour Charity, Brain Tumour Research, Meningioma UK and Brain & Spine Foundation offer information, peer support and financial advice.

Frequently asked

Everything we get asked about brain tumours.

Quick answers on how common they are, how they are diagnosed, what has changed and where to be treated.

  • How common are brain tumours in the UK?

    Around 12,000 primary brain and central nervous system tumours are diagnosed each year in the UK across all ages. In adults, brain metastases from cancers elsewhere in the body are many times more common than primary brain tumours, which is why any new neurological symptom in someone with a known cancer is taken seriously.

  • Are all brain tumours cancer?

    No. Some tumours, such as most meningiomas and many pituitary adenomas, are WHO grade 1 and behave in a benign way. Others, such as glioblastoma (WHO grade 4), are aggressive. Even a slow growing tumour can cause real symptoms because of where it sits, so the grade and the location both matter.

  • What symptoms should make me worry about a brain tumour?

    The classic red flags are a new or progressive headache that is worse in the morning or wakes you from sleep, a first seizure in an adult, new focal weakness, speech or visual change, personality change or endocrine symptoms such as galactorrhoea or bitemporal visual field loss. Any of these deserve prompt medical assessment and usually an MRI.

  • How is the diagnosis actually made?

    MRI brain with gadolinium is the imaging gold standard, often with perfusion, spectroscopy and functional sequences. A tissue biopsy at surgery is then tested for markers such as IDH, MGMT methylation and 1p/19q codeletion. The 2021 WHO CNS5 classification integrates what the tumour looks like under the microscope with these molecular markers to give a precise diagnosis.

  • What has changed recently in brain tumour treatment?

    Molecular profiling now drives treatment. Vorasidenib, an IDH1/2 inhibitor, was approved in 2024 for residual or recurrent IDH mutant grade 2 astrocytoma and oligodendroglioma after the INDIGO trial. Proton beam therapy is expanding, particularly for children and skull base tumours, and 5 ALA fluorescence guided surgery and intraoperative MRI help surgeons remove more tumour safely.

  • Where should I have my brain tumour treated?

    In the UK, complex brain tumour care is delivered at supraregional neuroscience centres, such as Queen Square, King’s, Cambridge, Oxford, Bristol, Newcastle, Sheffield, Manchester, Leeds, Birmingham, Cardiff, Edinburgh, Glasgow, Nottingham and Southampton. Ask to be referred to your nearest MDT and make sure you have a clinical nurse specialist to coordinate your care.

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