Is Your Headache a Brain Tumor Symptom?

How are headaches due to tumors different than other headaches?

Woman with headache
Image © David De Lossy / DigitalVision / Getty Images

When a headache gets worse or won't go away, it's natural to wonder whether the headache could be a symptom of something more serious, like a brain tumor.

Indeed, headaches can be a symptom of brain tumors, and those that are truly tumor-related often have distinct characteristics that separate them from headaches that have other causes.

But it's important to know that brain tumors are not common.

 While studies show that more people are being diagnosed with brain tumors than in the past, it still is an uncommon occurrence. Headaches are much more likely to be related to other, less serious conditions like migraines, allergies, or tension-type headaches

The Causes of Headaches in People Who Have Brain Tumors

Brain tumors can cause a headache by directly compressing a variety of structures in the skull, like large arteries and veins, the skull itself, or the cranial nerves that carry pain fibers.

Increased intracranial pressure (ICP) is another potential culprit of headaches in people who have brain tumors. ICP occurs when there is an increased amount of pressure placed on the brain caused by excess fluid, brain swelling, or an abnormal growth (called a tumor). Besides a headache, vomiting (often without nausea) may be another symptom of increased intracranial pressure.

It's important to note that when talking of brain tumors, we are talking about both benign (non-cancerous) and malignant (cancerous) tumors.

Since these tumors are growing within the enclosed space of the skull, and can put pressure on other structures, benign tumors can, at times, be as serious as malignant tumors.

Characteristics of a Brain Tumor Headache 

Surprisingly, headaches from brain tumors do not generally occur on their own, but rather along with other neurological symptoms such as:

  • Seizures
  • Changes in vision or hearing
  • A weakness of the arms and legs
  • Mood problems
  • Challenges with speaking (for example, slurred speech)
  • Cognitive decline (for example, memory loss)

It has been generally thought that a brain tumor-related headache is classically a morning headache that improves through the day, but research shows that this isn't always the norm. In fact, this may be more common in children with brain tumors than adults. Regardless, headaches are common in those who have brain tumors, with up to half of sufferers experiencing them.

The pain of a brain tumor headache can be described as dull and aching (similar to a tension-type headache), or less often throbbing (similar to either a migraine). It has also been described as being similar to uncommon primary headache disorders like a cluster headache or a primary exertional headache.

With time, a headache from a brain tumor usually becomes more frequent and increases in severity. In addition, changes in body position can make them worse, especially when lying down. They can also be worsened by coughing, sneezing, or bearing down for a bowel movement (this is called the Valsalva maneuver). 

These are only typical characteristics of brain tumors, as brain tumors are very complex.

It's important to understand that each person may experience different types of headaches based on the size of their tumor, its location, and how quickly or slowly it grows.

Questions Your Doctor May Ask You About a Potential Brain Tumor Headache

When you see your doctor because of frequent headaches, he or she will ask you several questions that are related to your headaches.

It is helpful to keep a symptom journal to clue your doctor in on what may trigger your headaches, what makes them worse, and how often you are getting them. These are all important factors and can easily be forgotten or under or over-estimated during the exam, so try to be as accurate as possible.

Here are some questions your doctor may ask you, and what your answers may reveal:

Do You Normally Get Headaches?

For people who don't normally get headaches and have had recent and new headaches, this may cause your doctor to suspect something more serious. In addition, people who have previously had headaches and whose headaches have changed in intensity or location, or have caused other symptoms, are also a concern to doctors. Overall, a change in headache pattern or a new, generally severe headache may be a symptom of a brain tumor.

What Medications Are You Using to Relieve Your Headaches?

Be very thorough and honest when your doctor asks about what you are doing to relieve your headaches. Tell him about any over-the-counter (OTC) medications such as ibuprofen or Tylenol (acetaminophen), herbs, or prescription medications that you are taking.

Even if you are taking pain medication that was prescribed for another condition or another person (neither of which is recommended and can be dangerous), it's vital to be honest with your doctor. He is not going to judge, as your physician simply wants to gauge how your headaches react to medications.

Typically, headaches related to brain tumors are not eased by medication. When both OTC and prescription pain relievers are ineffective, it raises a red flag for a doctor that something more serious may be going on.

What Makes Your Headache Better or Worse?

If your headaches worsen or are triggered when you bend over, sneeze, or cough, it's important to let your doctor know. Brain tumor-related headaches are often worsened by these movements, and a specialist will order the appropriate imaging tests and studies such as an MRI or a CT scan to rule out a brain tumor as the cause of your headache. 

Also, if your headache is getting gradually more severe and is waking you or your child up at night or after a daytime nap, this is something else you want to point out to your doctor.

Red Flags—When Further Work-Up is Needed For Other Reasons

In addition, there are some red flags that raise a physician's concern, and suggest that brain imaging is needed for a headache. Some of these red flags might be suggestive of a brain tumor, but there are other serious causes of headaches as well, such as a stroke, an aneurysm, brain metastases from cancer, or a bleed into the brain. If you have any of these red flags, contact your doctor immediately.

  • If it's the worst headache you've ever had.
  • If you have a severe headache while pregnant or after giving birth.
  • If you have a severe headache and have a compromised immune system due to chemotherapy, HIV/AIDS, or another condition.
  • If you have sudden severe pain on only one side of your head.
  • If you have a fever along with a severe headache.
  • If you have a headache plus any other neurological signs such as changes in speech, gait, memory, mood, or changes in vision or hearing.
  • If you have a severe headache and a have a gut feeling that something is seriously wrong (a feeling of impending doom). Trust your gut. 

A Word From Verywell

In the end, the vast majority of headaches are not from a brain tumor. If your doctor is suspicious that you might have a brain tumor, or another issue, such as a stroke, imaging tests such as an MRI can rapidly make the diagnosis. Sometimes, imaging tests can reduce your anxiety so that you can move forward with a treatment plan for resolving your headache.

When you meet with your doctor, express your fears. You know your body more than anyone, and are the best person to know when something is wrong. If your symptoms persist, follow-up again. If you aren't getting answers and are still concerned, consider a second opinion. Being your own advocate in your health is the best way to get the care you deserve.

Sources:

American Cancer Society. Signs and Symptoms of Adult Brain and Spinal Cord Tumors. Updated 11/06/17. https://www.cancer.org/cancer/brain-spinal-cord-tumors-adults/detection-diagnosis-staging/signs-and-symptoms.html

Lay, C., and C. Sun-Edelstein. Brain Tumor Headache. UpToDate. Updated 09/06/17.

Ropper. Adams and Victor's Principles of Neurology, 10e. N.p.: McGraw-Hill, 2014. Print.