Headache is the most common symptom of brain tumors. Although the brain itself feels no pain, other structures including blood vessels, the covering of the brain, and nerves in the head produce pain in response to pressure or displacement caused by a tumor. Brain tumors can occur at any age and may be cancerous (malignant) or noncancerous (benign). Headaches associated with brain tumors cause specific symptoms that help distinguish them from other types of headaches.
Early Morning Pain
Brain tumor-induced headaches are typically worst in the morning just after awakening. The pain may wake you up. The cerebrospinal fluid that surrounds the brain accumulates in the head when you are lying down. This increases pressure on the brain along with increased pressure from the growing tumor, causing early morning headache pain. Headaches associated with brain tumors characteristically ease as the day wears on.
Head Pain Relieved by Vomiting
Headaches caused by a brain tumor are often accompanied by vomiting, with or without nausea. This is due to increased intracranial pressure and often occurs in the morning, although it can occur at other times during the day. Headache pain that is relieved by vomiting is a typical symptom of brain tumor.
Head Pain Worsened by Straining
Straining commonly aggravates the head pain caused by a brain tumor. Coughing, sneezing, heavy lifting, and straining to have a bowel movement are typical triggers for increased head pain. The increased pain is due to a temporary increase in intracranial pressure than accompanies straining.
Head Pain Affected by Position
Positions that put the head low to the ground can aggravate head pain caused by a brain tumor. Bending or leaning over and stooping commonly increase headache pain because more cerebrospinal fluid flows into the head in these positions, causing increased pressure on the brain. Resuming an upright position typically relieves the increased level of head pain.
Progressively Worsening Head Pain
The pattern of headache pain can give clues to the underlying cause. Headaches associated with brain tumors tend to get progressively worse over time as the tumor grows and causes ever-increasing pressure within the skull. The pain may be mild and intermittent at first, but become more severe and persistent over several weeks to months.
Nonthrobbing Head Pain
Unlike many other forms of headache, the pain of a brain-tumor associated headache typically does not throb. This is because the pain comes from increased pressure on the brain due to the growing tumor and physical displacement of brain structures rather than by blood vessel spasms. Headaches caused by brain tumors typically present with dull, constant, aching pain. The pain is often located on the same side of the head as the tumor, although this is not always the case.
Head Pain Not Relieved by Over-The-Counter Pain Medications
Brain tumor-associated headaches are usually not relieved by over-the-counter pain medicines such as aspirin, acetaminophen (Tylenol) and ibuprofen (Advil, Motrin). This is in contrast to common types of headaches, such as tension-type headaches, which often resolve with these pain relievers.
Warnings and Precautions
Headaches are extremely common and the overwhelming majority are not due to a brain tumor. However, it's important not to ignore a new, different, severe or worsening headache, which could be due to a brain tumor or another serious condition. Seek immediate medical care if you experience a sudden headache accompanied by nervous system symptoms, such as numbness or tingling, weakness or paralysis, slurred speech or difficulty understanding speech. Other signs and symptoms that require urgent medical evaluation when occurring in combination with a headache include: -- fever or rash -- stiff neck -- decreased level of consciousness -- personality or behavioral change -- seizure -- vision change or eye pain -- dizziness or loss of coordination
Is This an Emergency?
- Merck Manual Professional Version: Approach to the Patient With Headache
- American Family Physician: Evaluation of Nausea and Vomiting
- Clinical Oncology, 3rd Edition; Matin D. Abeloff, M.D., et al.
- American Family Physician: Evaluation of Acute Headaches in Adults
- Family Practice Notebook: Headache Red Flag
- Merritt's Neurology, 12th Edition; Lewis P. Rowland and Timothy A. Pedley