The clinical manifestations when brain metastases occur are related to the site of metastasis and the size of the mass. For example, compression by surrounding tissues may produce increased intracranial pressure and manifestations of headache, vomiting and optic nerve papillary oedema.
If the brain parenchyma is invaded, psychiatric symptoms, epilepsy and sensorimotor disorders may occur. Invasion of the thalamus may result in sensory loss and involuntary movements. Cerebellar metastases may result in nystagmus and limb-motor coordination dysfunction. Some patients with meningeal metastases may present with progressive worsening of neck and shoulder pain, etc.