Headaches are very common, with most people experiencing them occasionally. While headaches are typically harmless, a persistent or worsening headache can sometimes be a sign of a more serious condition like a brain tumor. Understanding the specific features of a headache caused by a brain tumor can help identify when further evaluation is needed.
What are the typical features of a brain tumor headache?
There are certain characteristics that help distinguish a headache caused by a brain tumor from other types of headaches:
- New onset – The headache is a new symptom that you haven’t previously experienced.
- Progressive – The headache worsens gradually over time, becoming more severe and more frequent.
- Persistent – The headache doesn’t go away and persists continuously with little or no relief.
- Worse in the morning – The headache tends to be more severe when waking up in the morning.
- Associated symptoms – May be accompanied by nausea, vomiting, dizziness, vision changes, seizures, or focal neurological deficits like weakness on one side of the body.
- Wakes you from sleep – The headache causes you to wake up from sleep.
- Worsens with exertion or straining – Physical activity, coughing, or bearing down can exacerbate the pain.
- Unilateral location – The headache is localized to one side of the head.
While most people with brain tumors develop headaches with these types of features, it’s important to note that headaches can vary significantly. Some may experience very severe debilitating pain, while others have milder, subtler symptoms. The quality and nature of the headache can depend on the size and location of the tumor.
What does the headache pain feel like?
People often describe brain tumor headaches as:
- Throbbing or pulsing – The pain has a pulsating quality, like a heartbeat, that comes and goes in intensity.
- Piercing, stabbing, or sharp – Feels like something being stabbed into the head.
- Pressure or tightness – Feels like the head is being squeezed in a vice grip or compressed.
- Dull and aching – A constant ache that fluctuates in severity.
- Burning – A hot, searing, burning type of pain.
The location of pain depends on the location of the tumor but is often focused on one specific point on the head. The intensity can range from mild to completely debilitating. Many describe the pain as unlike any headache they’ve had before.
What areas of the head can the headache affect?
Headaches from brain tumors often affect one specific area of the head, unlike typical headaches which are more generalized. Areas that may be affected include:
- Frontal lobe – Forehead area
- Temporal lobe – Temples
- Parietal lobe – Top of the head
- Occipital lobe – Back of the head
- Cerebellum – Lower back of head toward the neck
- Brain stem – Base of the skull
- Pituitary gland – Behind the bridge of the nose/eyebrows
However, the pain isn’t always confined to the tumor location and can sometimes radiate to other areas of the head as well.
What other symptoms can accompany the headache?
Along with headache, other concerning symptoms to look out for include:
- Nausea and vomiting
- Dizziness
- Vision changes like blurriness, double vision, or loss of peripheral vision
- Seizures
- Cognitive changes like memory loss, confusion, or personality changes
- Weakness, numbness, or coordination problems
- Hearing loss
- Difficulty speaking
- Loss of consciousness
Because the brain controls all functions of the body, a brain tumor can cause almost any neurological symptom depending on its location. Headaches combined with other new neurological symptoms are most suspicious for a possible brain tumor.
What are some specific characteristics of common brain tumor headaches?
Different types of brain tumors can cause headaches with slightly different features:
| Tumor Type | Headache Characteristics |
|---|---|
| Meningioma | Chronic headache that progresses slowly over time, often focused on the area where the tumor is located. May worsen with exertion or straining. |
| Glioblastoma | Sudden onset severe headache that develops rapidly over days to weeks. Often described as the “worst headache of my life”. |
| Pituitary adenoma | Focused headache behind the eyes/bridge of nose, may cause vision changes or hormonal abnormalities. |
| Acoustic neuroma | Focused headache on one side behind the ear, associated with hearing loss on that side. |
| Lymphoma or leukemia | Headache that develops slowly over weeks to months, often worse in the morning and improves throughout the day. |
| Brain metastases | Sudden explosive headache, especially in someone with a history of cancer. |
These are some general patterns, but there can be significant variation and overlap between different tumor types.
How are brain tumor headaches diagnosed?
If a new, progressively worsening headache is suspected to be caused by a brain tumor, the doctor will perform a neurologic exam and obtain imaging studies of the brain such as an MRI or CT scan. This allows them to look for mass lesions in the brain that could explain the symptoms.
The headache history and description of symptoms provides clues, but a brain scan is needed for a definitive diagnosis. The results can identify if there is a brain tumor present, what type it is, and its exact size and location.
How are brain tumor headaches treated?
Treatment focuses on both relieving headache symptoms and treating the underlying brain tumor:
- Medications – Prescription medications like opioids or steroids may be used in the short term to relieve severe headache pain.
- Surgery – Removing all or part of the brain tumor may resolve the headaches in some cases.
- Radiation – Shrinking the tumor through radiation can provide headache relief for some tumor types.
- Chemotherapy – May be used alongside radiation for more aggressive, malignant tumors.
- Stereotactic radiosurgery – Precisely targeted radiation to the tumor while sparing surrounding tissue.
- Dexamethasone – Corticosteroid medication used to decrease inflammation and edema around the tumor.
- Anti-seizure medication – May be used both to prevent seizures and provide some pain relief benefit.
- Pain management – Specialists can provide pain relief techniques and medications to make headaches more tolerable.
Addressing the underlying cause through tumor treatment is the most definitive way to resolve a brain tumor headache. But controlling pain and other symptoms is an important part of improving quality of life and allowing you to maintain your daily activities.
When to seek emergency help for a headache
While most headaches are not an emergency, you should seek immediate medical attention if you experience:
- Sudden, severe “thunderclap” headache that reaches maximum intensity within minutes.
- Headache with fever, neck stiffness, and altered mental state.
- New headache along with seizures, weakness, numbness, or difficulty speaking.
- Headache that continues to worsen despite medication treatment.
- Headaches that prevent normal functioning.
- Very frequent headaches that occur daily and seem to have no explanation.
Rapidly worsening, persistent, or debilitating headaches can be a sign of something serious like bleeding, infection, or tumor growth needing emergency care. Seek help immediately if your headaches seem life-threatening.
Conclusion
Headaches caused by brain tumors often have distinctive features like being progressively worsening, persistent, or associated with other neurological symptoms. While the pain can vary in nature and intensity, a new severe headache that is unusual or concerning for you should be evaluated promptly. Getting an accurate diagnosis is essential, as prompt brain tumor treatment can relieve headaches and prevent serious complications. Tracking your headache patterns and symptoms can help your doctor determine if imaging tests are needed to look for a brain tumor or other neurological cause.