This news article aims to differentiate common headaches, like migraines, from headaches potentially caused by brain tumors, clarifying that while headaches are a symptom of brain tumors, they are a less frequent cause than migraines. Key characteristics of migraines include unilateral pain, photophobia, phonophobia, nausea, vomiting, and association with aura, typically lasting 4 to 72 hours and worsening with activity. In contrast, brain tumor headaches are often persistent, occurring in the early morning, disrupting sleep, and may be accompanied by severe vomiting, worsening with coughing or sneezing, and potentially presenting with focal neurological signs such as weakness, speech difficulties, cognitive impairment, seizures, personality changes, or visual disturbances. Diagnosis involves a neurological examination, fundus examination for papilledema, and typically an MRI of the brain to identify primary or metastatic tumors, emphasizing that while not all headaches indicate a tumor, the presence of additional focal symptoms is crucial for diagnosis.

This news article aims to differentiate common headaches, like migraines, from headaches potentially caused by brain tumors, clarifying that while headaches are a symptom of brain tumors, they are a less frequent cause than migraines. Key characteristics of migraines include unilateral pain, photophobia, phonophobia, nausea, vomiting, and association with aura, typically lasting 4 to 72 hours and worsening with activity. In contrast, brain tumor headaches are often persistent, occurring in the early morning, disrupting sleep, and may be accompanied by severe vomiting, worsening with coughing or sneezing, and potentially presenting with focal neurological signs such as weakness, speech difficulties, cognitive impairment, seizures, personality changes, or visual disturbances. Diagnosis involves a neurological examination, fundus examination for papilledema, and typically an MRI of the brain to identify primary or metastatic tumors, emphasizing that while not all headaches indicate a tumor, the presence of additional focal symptoms is crucial for diagnosis.

This news article aims to differentiate common headaches, like migraines, from headaches potentially caused by brain tumors, clarifying that while headaches are a symptom of brain tumors, they are a less frequent cause than migraines. Key characteristics of migraines include unilateral pain, photophobia, phonophobia, nausea, vomiting, and association with aura, typically lasting 4 to 72 hours and worsening with activity. In contrast, brain tumor headaches are often persistent, occurring in the early morning, disrupting sleep, and may be accompanied by severe vomiting, worsening with coughing or sneezing, and potentially presenting with focal neurological signs such as weakness, speech difficulties, cognitive impairment, seizures, personality changes, or visual disturbances. Diagnosis involves a neurological examination, fundus examination for papilledema, and typically an MRI of the brain to identify primary or metastatic tumors, emphasizing that while not all headaches indicate a tumor, the presence of additional focal symptoms is crucial for diagnosis.

Headaches are a common symptom faced by many of us. A common question that comes to everybody’s mind after experiencing a headache is – could it be a brain tumour?

Migraine is a very common cause of headache. The classical migraine symptom would be a unilateral headache associated with photophobia or phonophobia. It could be associated with nausea or vomiting. This headache tends to increase with activity and reduce with rest. They tend to last anywhere between 4 to 72 hours. They can be associated with an aura, which is a premonitory symptom. These are usually characterised by visual symptoms like zig-zag lines, blind spots called scotoma or fortification spectra.

Brain tumours usually have a slow course characterised by cognitive impairment, depending upon which part of the brain is involved. They can be associated with seizures. There may be personality or behavioral changes. If there is a change in behavior over the last few months, this is a diagnosis that should be considered. If the tumour affects the motor fibers in the brain, it can present as weakness of a particular side.

Headache is an important symptom of brain tumours. They present with usually early morning headaches. They may disrupt sleep, and people tend to wake up with a headache. They can be associated with severe vomiting. A headache can be present throughout the head or can be localised to a particular side. It can worsen with coughing or sneezing, which can increase the intracranial pressure. Any new onset headache in an otherwise normal individual with cognitive, memory, or behavioral symptoms, this diagnosis needs to be kept in mind. There will be additional symptoms like behavioral changes or memory changes.

When can a headache be suggestive of a brain tumour?

The headaches of a brain tumour can be easily differentiated from migraine. Migraines are usually episodic. In brain tumour headaches, they may be persistent, which can make the patient wake up at night. The patient may have the following symptoms:

  • Weakness of arms or legs
  • Speech difficulties like slurring or language abnormalities
  • Swallowing difficulty
  • Numbness in the face, arms, or legs
  • Hearing loss
  • Visual symptoms like double vision, field defects
  • New onset seizure

How to diagnose?

A simple neurological examination will help in the diagnosis. Fundus examination may show some findings of increased brain pressure called papilledema. There may be visual field defects or subtle weakness on a particular side.

The test usually ordered is an MRI of the brain. which usually picks up most of the tumours. The tumours may be a primary brain tumour that is arising only from the brain or a metastatic tumour that is spread to the brain from other parts of the body.

Not all headaches are due to a brain tumour; it constitutes a small fraction of the overall causes. The additional focal symptoms help us in getting a diagnosis.

(The author is a consultant neurologist, KMC Hospital, Mangalore)

The opinions expressed in this article are those of the author and do not purport to reflect the opinions or views of THE WEEK.

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