A new and abnormal formation of tissue as a tumor or growth is termed a neoplasm. A cancerous tumor is a growth that may penetrate tissue, metastasize, or recur after removal. Cancerous new growths are marked by uncontrolled spread of abnormal cells. Cancers may be deadly by invading adjacent normal tissues or by spreading to sites distant from the place of origin. Malignant brain tumors grow rapidly and invade other tissues; however, they rarely spread beyond the central nervous system (CNS). Death may be caused by harmful local growth. A brain tumor also may be referred to as an intracranial neoplasm.

The cause of malignant brain tumors is unknown.

The signs and symptoms of malignant intracranial neoplasms will vary, and depend on the type, size, and location of the tumor. General manifestations are created by increased intracranial pressure. Signs and symptoms of increased intracranial pressure include: headaches; vomiting; convulsive seizures; drowsiness; lethargy; and listlessness. Other manifestations that may be present include: impaired mental faculties; aphasia; anosmia; visual field defect; exophthalmos and loss of the ability to write (agraphia). In addition, other signs and symptoms may include: inability to remember names (anomia); impaired skin sensitivity; eating disorders; weakness, imbalance or double vision.

Diagnostic measures may include: a complete neurologic consultation; biopsy; tests of visual fields and acuity; audiometry; computed tomography (CT) scan; magnetic resonance imaging (MRI); and cerebral angiography.

Treatment depends on the type and location of the tumor, and may include: surgical removal; radiation therapy; chemotherapy; diuretics and corticosteroids.

Residuals may include neurologic deficits that may disable the person physically and mentally. The person may require self-care aids such as bathroom rails and wheelchairs, and assistance with activities of daily living (ADL). Speech therapy may be required if speech impairment is present. Symptoms may increase with radiation therapy before they decrease. Surgical removal and radiation may allow the person to return to an active life. Patient and family must be aware of early signs of recurrence; signs and symptoms of increased intracranial pressure.

• In those cases where there is severe neurologic deficit, consider entitlement under 38 CFR 3.350 [Special monthly compensation ratings]; competency under 38 CFR 3.353 [Determinations of incompetency and competency]; ancillary benefits under 38 CFR 3.807; 38 CFR 3.808 [Automobiles or other conveyances]; 38 CFR 3.809 [Specially adapted housing]; and 38 CFR 3.809a [Special home adaptation grants].

• This disease shall be granted service connection although not otherwise established as incurred in or aggravated by service if manifested to a compensable degree within the applicable time limits under 38 CFR 3.307 following service in a period of war or following peacetime service on or after January 1, 1947, provided the rebuttable presumption provisions of 38 CFR 3.307 are also satisfied [38 CFR 3.309 .  [Disease subject to presumptive service connection], 38 CFR 3.309 (a) [chronic disease].

• Malignant neoplasms of the brain shall be service connected if the veteran was in a radiation risk activity as defined by 38 CFR 3.309 [Disease subject to presumptive service connection, 38 CFR 3.309(d), Diseases specific to radiation-exposed veterans] provided the rebuttable presumption provisions of 38 CFR 3.307 of the part are also satisfied; and for the brain and central nervous system under 38 CFR 3.311 [Claims based on exposure to ionizing radiation], and 38 CFR 3.311(b) [Initial review of claims] provided the provisions of 38 CFR 3.311(b)(5)(iv) have been met. A claim under 38 CFR 3.311 that involves radiation exposure requires an opinion by the C&P Service before any decision may be made by a Regional Office to grant or deny benefits.

• May be entitled to special monthly compensation where the veteran has a single service-connected disability rated as 100% with additional service-connected disability or disabilities independently ratable at 60% or more, which are separate and distinct from the 100% service-connected disability and involves different anatomical segments or bodily systems. See  38 CFR 3.350(i)(1) – Special Monthly Compensation (SMC)

Notes

• The rating in code 8002 will be continued for 2 years following cessation of surgical, chemotherapeutic or other treatment modality. At this point, if the residuals have stabilized, the rating will be made on neurological residuals according to symptomatology.

• It is required for the minimum ratings for residuals under diagnostic codes 8000-8025, that there be ascertainable residuals. Determinations as to the presence of residuals not capable of objective verification, i.e., headaches, dizziness, fatigability, must be approached on the basis of the diagnosis recorded; subjective residuals will be accepted when consistent with the disease and not more likely attributable to other disease or no disease. It is of exceptional importance that when ratings in excess of the prescribed minimum ratings are assigned, the diagnostic codes utilized as bases of evaluation be cited, in addition to the codes identifying the diagnoses.

• Disability in this field is ordinarily to be rated in proportion to the impairment of motor, sensory or mental function. Consider especially psychotic manifestations, complete or partial loss of use of one or more extremities, speech disturbances, impairment of vision, disturbances of gait, tremors, visceral manifestations, injury to the skull, etc. In rating disability from the conditions in the preceding sentence refer to the appropriate schedule. In rating peripheral nerve injuries and their residuals, attention should be given to the site and character of the injury, the relative impairment in motor function, trophic changes, or sensory disturbances.  38 CFR 4.120

• With the exceptions noted, disability from the following diseases and their residuals may be rated from 10 percent to 100 percent in proportion to the impairment of motor, sensory, or mental function. Consider especially psychotic manifestations, complete or partial loss of use of one or more extremities, speech disturbances, impairment of vision, disturbances of gait, tremors, visceral manifestations, etc., referring to the appropriate bodily system of the schedule. With partial loss of use of one or more extremities from neurological lesions, rate by comparison with the mild, moderate, severe, or complete paralysis of peripheral nerves” 38 CFR 4.124a