Updated August 18, 2014.
Written or reviewed by a board-certified physician. See About.com's Medical Review Board.
Let's be candid here. The majority of headaches are not worrisome. While headaches can be especially burdensome, particularly a migraine or cluster headache, they usually go away eventually with time and/or medication.
The headache of a brain tumor, though, does not go away. It's classically constant (or becomes increasingly frequent), even when you are sleeping. It can also be accompanied by other alarming signs, like seizures and/or fainting.
That being said, headache is sometimes the only symptom of a brain tumor.
What is a Brain Tumor Headache?
Headache is the worst symptom in about 50% of patients with a brain tumor. Usually, the pain of a brain tumor headache is dull and occurs all the time. Sometimes, it is throbbing. Headaches from brain tumors are usually worse at night, and patients will commonly report that the pain wakes them from their sleep. The headache often occurs or is worse on the same side as the tumor. But, the headache can also be generalized, especially if it is due to increased intracranial pressure (ICP) or hydrocephalus.
What is hydrocephalus? Hydrocephalus refers to excessive cerebrospinal fluid (CSF) in the brain. CSF is the normal fluid that surrounds and cushions your brain and spinal cord. If a tumor obstructs normal flow of this fluid, it causes a buildup, creating lots of pressure. As you can image, this pressure may cause various symptoms including: pain, vomiting, seizures, and papilledema.
What is A Headache from Increased ICP or Hydrocephalus Like?
According to the second edition of the International Classification of Headache Disorders (ICHD-II), symptoms of a headache attributed to increased ICP or hydrocephalus (from a brain tumor) are:
- diffuse
- non-pulsating
AND associated with at least one of the following features:
- Nausea and/or vomiting
- Worsened by physical activity and/or maneuvers that will increase intracranial pressure (ICP). Examples of such maneuvers include: coughing or sneezing (Valsalva maneuver)
- Pain occurs in "attack-like episodes." (Please note though that sometimes the headache from a brain mass is instead a sudden thunderclap headache that causes a loss of consciousness.)
Additionally, there must be a "space-occupying intracranial tumor" shown on CT or MRI of the brain that is causing the hydrocephalus.
Finally, if your headache is from a brain mass that is causing an increased ICP, it will coincide with the development of the fluid buidup and improve within 7 days of surgical removal or reduction of the tumor.
What are Other Symptoms of a Brain Tumor Besides a Headache?
- Seizures
- Nausea and Vomiting
- Loss of Consciousness
- Memory Loss
- Mood Disturbances (i.e. Depression) and/or Personality Changes
- Muscle Weakness
- Difficulty with Language (i.e. slurred speech)
- Vision Problems
Most headaches are not brain tumors. But, a persistent headache and/or headache that follows a different pattern from your typical headache is a sign that you need to speak with your doctor to make sure there is nothing else going on.
Remember too, not all brain tumors even cause headaches. Other symptoms, like behavior changes or muscle weakness, may be the only clue. If you have any concerns, please speak with your healthcare provider. More information about brain tumors and its symptoms can be read in "What is Brain Cancer?"
Sources
Campos S, Davey P, Hird A, Pressnail B, Bilbao J, Aviv RI, et al. Brain metastasis from an unknown primary, or primary brain tumour? A diagnostic dilemma. Curr Oncol. Jan 2009; 16(1): 62–66.
Headache Classification Subcommittee of the International Headache Society. "The International Classification of Headache Disorders: 2nd Edition". Cephalalgia 2004;24 Suppl 1:9-160.
Wong ET, Wu JK. Clinical presentation and diagnosis of brain tumors. In: UpToDate, Basow DS (Ed), UpToDate, Waltham, MA, 2013.
http://www.ninds.nih.gov/disorders/hydrocephalus/detail_hydrocephalus.htm. Accessed August 2014.
http://www.ninds.nih.gov/disorders/brainandspinaltumors/brainandspinaltumors.htm. Accessed August 2014.
DISCLAIMER: The information in this site is for educational purposes only. It should not be used as a substitute for personal care by a licensed physician. Please see your doctor for diagnosis and treatment of any concerning symptoms or medical condition.
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