2010 BC Guide in Determining Fitness to Drive

Chapter 26: Intracranial TumoursBACKGROUND26.1 About intracranial tumoursIntracranial tumours are tumours that develop inside the cranium, the upper portion of the skullthat protects the brain. Primary tumours are those which originate from within the cranium andmetastatic tumours are those which result from cancers which spread (metastasize) from otherparts of the body. Metastatic tumours are by far the more common type of intracranial tumour inadults, 10 times more common than primary tumours.Primary tumours may be classified as either benign (non-cancerous) or malignant (cancerous).Malignant tumours are graded on a scale of 1 to 4, with grade 4 being the most severe, based onhow abnormal they are compared to normal tissue and how quickly they are likely to grow andmetastasize.Typically, the treatment options for intracranial tumours are surgery, radiation andchemotherapy, alone or in combination, regardless of whether the tumour is primary ormetastatic, benign or malignant. For primary tumours, the probability of successful treatmentdepends on a number of factors, including the type of tumour, the size and the location.Treatment will rarely cure a metastatic tumour, and the goal of treatment is generally to reducesymptoms, increase length of survival, and improve quality of life.Impairments associated with intracranial tumours vary depending on the type, location and rateof growth of the tumour and can affect cognitive, motor, or sensory functions. Possibleimpairments include: cognitive impairment epilepsy personality changes focal weakness, and sensory disturbances.The presentation of impairments may be progressive or variable.26.2 Prevalence and incidence of intracranial tumoursThe overall incidence of intracranial tumours in the United States is between 5 and 14 per100,000 people (all ages), with the peak incidence in those between 65 and 79 years of age.Canadian data are lacking.329