Headaches are very common, with most people experiencing them occasionally. In the vast majority of cases, headaches are not caused by a brain tumor. However, in some instances, persistent and worsening headaches can be a sign of a brain tumor.
Brain tumor headaches tend to have distinct characteristics that set them apart from other types of headaches. Understanding the signs and symptoms of a brain tumor headache can help identify when further investigation may be needed.
Common Locations and Types of Brain Tumors
Brain tumors can develop in any part of the brain, but certain locations are more common than others:
- Frontal lobe – located behind the forehead
- Parietal lobe – top area near the back of the head
- Temporal lobe – bottom area near the ears
- Occipital lobe – back area of the brain
- Cerebellum – lower back part of the brain
- Brain stem – central stalk leading down from the brain
The most common types of primary brain tumors include:
- Gliomas – arise from glial cells that support nerve cells
- Meningiomas – develop from the meninges membranes surrounding the brain
- Pituitary adenomas – grow in the pituitary gland at the base of the brain
- Medulloblastomas – form in the cerebellum, more common in children
- Acoustic neuromas – develop on nerves leading from the inner ear to the brain
Secondary brain tumors begin elsewhere in the body and spread to the brain. Lung, breast, and skin cancers commonly metastasize to the brain.
Characteristics of a Brain Tumor Headache
While every person’s experience is unique, there are some hallmark features that set brain tumor headaches apart:
Location
Brain tumor headaches frequently occur on one side of the head only. Most other types of headaches, like migraines, tend to cause pain on both sides.
The location of the pain often matches the location of the tumor in the brain. For example, a tumor in the frontal lobe can cause persistent frontal headaches behind the forehead.
Timing
Headaches that are worst in the morning are more characteristic of brain tumors. The increased pressure in the skull overnight from lying down exacerbates the pain.
Many brain tumor headaches tend to be worse at night or wake people from sleep. The pain may ease somewhat during the day when upright.
Nausea and Vomiting
Nausea and vomiting commonly accompany brain tumor headaches, more so than with other headache types. This occurs because the brain tumor increases pressure inside the skull, irritating the brain tissue and nerves involved in nausea.
Persistent and Progressive
Brain tumor headaches tend to be relentless and gradually worsen over time. The pain can fluctuate but becomes more constant and severe. Primary headaches like migraines and cluster headaches cycle through intense flare-ups and pain-free periods.
Triggered by Coughing/Straining
Activities that increase intracranial pressure often worsen brain tumor headaches. Coughing, sneezing, straining, bending over, or other Valsalva maneuvers can trigger or intensify the headache.
Unusual Sensations
Brain tumor headaches may cause additional unusual symptoms not typical for other headache types. These can include:
- Burning, stabbing, or electrical sensations
- Flashing lights or visual disturbances
- Dizziness
- Memory issues
- Changes in coordination
- Personality changes
- Seizures
No Response to Medication
While many headaches respond to over-the-counter pain relievers like ibuprofen or Tylenol, brain tumor headaches often do not. The medications may dull the pain briefly, but it continues to return. If a headache persists despite medication, it warrants medical evaluation.
What Does a Brain Tumor Headache Feel Like?
People often describe brain tumor headaches as:
- Throbbing/Pulsating – This rhythmic pulse follows the heartbeat and blood flow. It often wakes people during the night.
- Piercing/Stabbing – These very severe headaches feel like being stabbed with a knife. The pain is explosive at onset.
- Tightening/Pressing – There is a constant sensation of pressure building up, as if the head is in a vise. This gets steadily worse.
- Dull/Aching – This is a continuous headache that may fluctuate in intensity. The pain feels like constant soreness.
- Burning – A hot, searing, burning type of pain in the head. This can be in a localized area or more generalized.
People also use terms like exploding, crushing, and excruciating to convey the extreme pain of a brain tumor headache.
Why Does a Brain Tumor Cause Headaches?
There are a few mechanisms by which brain tumors trigger headaches:
Increased Intracranial Pressure
The growth of a tumor takes up space inside the rigid skull. This raises pressure in the intracranial space surrounding the brain, squeezing and displacing brain tissue. The arteries and veins around the tumor also get compressed. This directly stimulates the pain-sensing nerves in the meninges membranes and blood vessels.
Disturbed Brain Tissue
As the tumor expands, it pushes on and distorts normal brain tissue. This can irritate the pain-sensitive structures on the brain surface. Tumors near the base of the brain may obstruct cerebrospinal fluid drainage, also increasing pressure.
Surrounding Inflammation
The tumor and pressure on the brain trigger inflammation. Swelling and immune cells release chemicals that stimulate pain nerves and make nerve endings extra sensitive. This enhances the pain signals sent to the brain.
Disrupted Blood Flow
Compressing blood vessels restricts blood flow to parts of the brain. The lack of oxygen triggers the release of chemicals that dilate blood vessels and excite pain nerves. Rebound increased blood flow when vessels reopen also activates pain receptors.
| Brain Tumor Headache Mechanism | Effect |
|---|---|
| Increased intracranial pressure | Directly stimulates meningeal pain nerves |
| Disturbed brain tissue | Irritates surface pain nerves |
| Surrounding inflammation | Activates and sensitizes pain nerves |
| Disrupted blood flow | Triggers release of pain chemicals |
When to See a Doctor
While most headaches have benign causes, a persistent, worsening headache requires medical evaluation. Contact a doctor promptly if a headache:
- Develops suddenly and is severe
- Worsens despite medication treatment
- Occurs with neurological symptoms like weakness, vision changes, dizziness, confusion, seizures
- Causes early morning vomiting
- Is accompanied by fever and neck stiffness
Seek emergency care immediately for the “worst headache of your life”, sudden severe headache, or head pain with loss of consciousness.
Medical Evaluation
To diagnose a brain tumor, a doctor will ask about your symptoms, medical history, and perform a neurological exam. They may order tests such as:
- Neuroimaging – CT scan, MRI scan, PET scan to visualize the tumor
- Lumbar puncture – sample of cerebrospinal fluid to detect cancer cells
- Angiogram – dye injected to outline blood vessels on an X-ray
- Skull X-ray – detect calcium deposits or erosions from tumor
- Neurological testing – EEG, evoked potentials to assess brain function
Identifying the type of tumor based on its location, cell origin, and appearance guides treatment options. Even noncancerous tumors require treatment if they are causing severe headaches.
Brain Tumor Headache Treatment
Treatment aims to eliminate the tumor and relieve headache pain. Options may include:
Surgery
Surgical removal of accessible tumors can instantly reduce intracranial pressure and headaches. Surgery also allows for tumor tissue analysis.
Radiation Therapy
High energy radiation is delivered to the tumor to damage its DNA and cause cell death. This shrinks the tumor to alleviate headaches.
Chemotherapy
Cancer killing drugs are administered systemically or injected into the cerebrospinal fluid. This chemical treatment destroys tumor cells.
Corticosteroids
Medications like dexamethasone reduce swelling around the tumor to decrease headaches. But steroids are not a definitive treatment solution.
Pain Medication
Over-the-counter or prescription analgesics can temporarily relieve headache pain. Narcotics may be needed for severe pain.
VP Shunt
Surgically placing a shunt catheter to drain excess cerebrospinal fluid from the brain alleviates pressure.
Headache Relief Tips
In addition to medical treatment, the following methods may provide some comfort from brain tumor headache pain and symptoms:
- Cold compress on the head and neck
- Relaxation techniques like meditation
- Massage therapy
- Biofeedback training
- Hydration and caffeine avoidance
- Comfortable low-light environment
- Avoiding straining or Valsalva maneuvers
Prognosis
The outlook for brain tumor headaches depends on the type, size, location of tumor and how early it is detected. While not all tumors are cancerous, even benign growths can permanently damage brain tissue and nerves if untreated. Brain cancer also has the ability to spread to other areas.
With aggressive treatment of the tumor, many headaches resolve after the growth has been controlled. But some may experience permanent headache issues even after treatment due to irreversible nerve injury and scarring.
Conclusion
A new persistent headache, especially with neurological symptoms, prompts an evaluation for potential causes including brain tumor. Though not all headaches are brain-related, certain red flag characteristics of brain tumor headaches help identify when imaging tests are warranted. Diagnosing and treating the underlying tumor can prevent permanent brain damage and provide definitive headache relief.