All 1978 US death certificates for which the registered underlying cause of death was nervous system (NS) tumors were identified (n = 9,841). For each case, 2 control deaths were matched by age, race, sex, and county and year of death. The frequency with which other conditions appeared on the death certificates of cases and controls was compared. The results emphasize the importance of differentiating primary from metastatic NS tumors; aggressively managing infections; treating acute vascular events as emergencies, and identifying a group at high risk for developing an NS tumor.