Neurological and vascular complications of primary and secondary brain tumours: EANO-ESMO Clinical Practice Guidelines for prophylaxis, diagnosis, treatment and follow-up

•This EANO-ESMO Clinical Practice Guideline provides key recommendations on the management of neurological and vascular complications brain tumours.•Authorship includes a multidisciplinary group experts from different institutions countries in Europe abroad.•Treatment are provided, including levels evidence grades recommendation where applicable.•Brain tumour patients need close clinical monitoring because frequency complications.•Early recognition appropriate key. The central nervous system (CNS) is affected by large variety primary tumours metastases cancers originating other organs. Brain carry high morbidity associated with range that rare affecting anatomical locations. Neurological symptoms signs related to area CNS involved. There no symptom or sign specific secondary tumours. Focal lateralised effects local tissue destruction include hemiparesis, aphasia visual field deficits. These often present subacutely show progressive course over some days weeks. Leptomeningeal disease typically leads multifocal symptoms. Most frequently, headaches, nausea vomiting, mental changes, gait difficulties, cranial nerve palsies focal irradiating (radicular) neck back pain.1Le Rhun E. Weller M. Brandsma D. et al.EANO-ESMO Guidelines for diagnosis, treatment follow-up leptomeningeal metastasis solid tumours.Ann Oncol. 2017; 28: iv84-iv99Abstract Full Text PDF PubMed Scopus (92) Google Scholar Unspecific raised intracranial pressure headache, without cognitive impairment, personality changes disturbances. caused direct growing oedema, impairment cerebrospinal fluid (CSF) circulation consecutive hydrocephalus. typical holocephalic unilateral throbbing tumour-related headaches accentuated after supine position, e.g. morning, improve period upright time during day.2Comelli I. Lippi G. 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Galanis DeGroot J.F. trial end points high-grade glioma: evolving landscape.Neuro 2011; 13: 353-361Crossref (84) require strategies optimal prevention, therapy follow-up, necessitate cooperation. current European Association (EANO)-European Society Medical Oncology (ESMO) joint guidelines summarise most observed cover seizures, neurocognitive venous thromboembolism, stroke, haemorrhage, metastatic spinal cord compression (MSCC) supportive end-of-life care. Due lack high-level these topics, based expert opinion consensus. They aim at guiding care serve helpful resource physicians health providers. For future, prospective trials specifically enrolling needed better define diagnostic therapeutic measures this patient group. Primary frequently surrounded oedema. This condition almost entirely found malignant neoplasms but occurs context benign such meningiomas. As consequence, vast majority will receive anti-oedema point course.5Hempen C. Weiss Hess C.F. 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