Health Problem Fact

Headache As a Symptom of a Brain Tumor

When headaches begin to get worse or don't go away, it is natural to wonder if the headache could be a symptom of something more serious, like a brain tumor. Headaches /can/ be a symptom of brain tumors, and

those that are truly tumor-related have distinct characteristics that separate them from other conditions that cause headaches.

First, it's important to known that brain tumors are not common. While studies show that more people are being diagnosed with brain tumors, it remains to be an uncommon occurrence. Chronic headaches are likely to be related to other, less serious conditions like migraines, allergies, or common vision problems that require glasses or contact lenses.

What Causes Headaches in People with Brain Tumors

Increased intracranial pressure (IICP) is a common culprit of headaches in people with brain tumors. IICP is an increased amount of pressure on the brain that can be caused by excess fluid, brain swelling, or a mass. There is only enough space in the skull to really accommodate the brain and a normal amount of fluid -- anything excess, whether it is fluid or tissue, increases the pressure.

Characteristics of Brain Tumor Headache

Surprisingly, headaches are not normally the initial symptom a person experiences if they have a brain tumor. Other symptoms, like seizures, changes in vision or hearing, weakness of the arms and legs, or cognitive decline are often the first symptoms.

It has been generally thought that a classic characteristic of a brain tumor-related headache was a morning headache, but research shows that this isn't exactly the norm. It can occur, but isn't as common as previously thought. Headaches, though, are common in those with brain tumors, with up to half of sufferers experiencing them.

Most people do not suffer from severe, debilitating headaches, although they can be painful enough to rouse someone from sleep. Headaches that awaken one from sleep can indicate something serious, but can also be caused by something other than a brain tumor. People suffering from brain tumors have complained of headaches awakening them, however.

The pain can be described as dull, aching, or throbbing. Over time, the headaches may become more frequent, increasing in severity, and eventually be a constant occurrence that is not easily relieved. Changes in body position can make them worse, especially when lying down. They can also be worsened by coughing or sneezing.

These are only typical characteristics of brain tumors. Brain tumors are very complex, and each person may experience different types of headaches that may or may not reflect these common traits.

Reasons Why Your Doctor May Suspect a Brain Tumor Because of Headaches

When you see your doctor because of frequent headaches, he will ask you several questions related to your headaches. It is helpful to keep a symptom journal to clue your doctor in on what may trigger the headaches, what makes them worse, and how frequently you are getting them. These are all important factors and can easily be forgotten or under/overestimated during the exam.

Your doctor will ask you several questions about your headaches. Here are some common ones and what your answers may reveal:

*Do you normally have headaches or previously suffered from headaches?

People who have previously suffered from headaches or who are allergy or migraine sufferers generally don't raise concern for doctors. It is those who don't commonly get headaches and have had recent and new headaches that make doctors suspect something more serious. People who have previously suffered from headaches and whose headaches have changed in intensity, location, or caused other symptoms are also a concern to doctors. A change in headache pattern can be a symptom of a brain tumor.

*What medicines you are using to relieve the headaches and are they working?

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 medication (such as ibuprofen or acetaminophen), herbs, or prescription medications you are taking. Even if you taking prescription pain medications that were prescribed for another condition or even another person, it is vital to tell your doctor. He or she is not going to judge. Your physician wants to gauge how your headaches react to medications. Typically, headaches related to brain tumors are not relieved by medication. When both OTC and prescription pain relievers are ineffective, it raises a red flag to a doctor that something more serious may be present.

*Please note that taking medication that is not prescribed for you is never recommended. You should also never take prescription pain medication for pain or symptoms that are unrelated to why your physician prescribed them originally.

*Do your headaches get better or worse with movement?

If your headaches worsen or are triggered by bending over, sneezing, or coughing, it is important to let your doctor know. Brain tumor-related headaches are often worsened by these movements.

*Are you experiencing any nausea or vomiting?

Nausea and vomiting along with a headache can be a symptom of a brain tumor. Nausea and vomiting without a headache, often with change of movement, can also be a symptom, but this is far more likely related to

something other than a brain tumor.

Sources:

DeAngelis, Lisa M. Brain Tumors N Engl J Med 2001 344: 114-123

S. M. Chang, I. F. Parney, W. Huang, F. A. Anderson Jr, A. L. Asher, M. Bernstein, K. O. Lillehei, H. Brem, M. S. Berger, E. R. Laws, et al. Patterns of Care for Adults With Newly Diagnosed Malignant Glioma JAMA, February 2, 2005; 293(5): 557 - 564.

S. M, A C Lamont, N A Alias, and M N Win Red flags in patients presenting with headache: clinical indications for neuroimaging Br. J. Radiol., August 1, 2003; 76(908): 532 - 535.