I Have a Terrible Headache. Is It a Brain Tumor?

It’s not uncommon to fear the worst when you have a symptom that pops up out of the blue, like a really bad headache. But here’s the good news: If you are well enough to be surfing the Internet for brain tumor symptoms, the chance you have one is miniscule. In fact, the likelihood of developing a brain tumor is less than 1 percent in a lifetime.

Headaches are one of the most common neurologic complaints in emergency departments. A sudden headache can be scary, especially if you don’t usually get them. They may present in many shapes and forms, from sharp and throbbing to aching and stabbing, all with varying degrees of severity and duration. However, a single headache, no matter how painful, is not a brain tumor symptom.

Most tumors are usually asymptomatic until they grow large enough to wreak real havoc. Patients end up seeing a specialist for care after a seizure, stroke or another serious symptom sends them to the emergency room, where a scan identifies a brain mass.

What Is a Brain Tumor?

Tumors are thought to arise from damaged, or mutated, genes of a single cell. As the mutated cell grows and multiplies, it forms an abnormal mass of tissue called a neoplasm or tumor. Tumors can occur anywhere in the body. In the brain, scientists have identified more than 100 distinct types of tumors, each with its own array of symptoms, treatments and outcomes.

Brain tumors are graded on a scale of 1 (most benign) to 4 (most malignant), but those designations can be misleading because survival rates depend not just on the grade but also on where the tumor is located, the patient’s age, and how the tumor responds to treatment. In other words, a tumor once labeled benign can become malignant.

Despite life-saving advances in so many forms of cancer, survival rates for brain tumors remain largely unchanged for many reasons, including:

• They are rarely detected when small because they’re typically asymptomatic until they grow large enough to press on other brain tissue.
• Their location in the brain, where every inch has a vital function, prevents total surgical removal of the tumor and its margins. Some residual tumor may be left behind to be treated with chemo and radiation therapy.
• About half of all primary malignant brain tumors are glioblastoma tumors, a form of cancer and one of the most malignant tumors of the human body, adept at evading the immune response and the brain's natural defenses, making them difficult to treat. 
• Brain tumors, benign or malignant, do not metastasize to the rest of the body – they stay local.

Brain Tumor Symptoms

Brain tumor symptoms get progressively worse.

As a brain tumor grows, it may disrupt normal electrical conduits in the brain, leading to seizures. Two-thirds of all people diagnosed with a brain tumor will experience at least one seizure, making seizures the most common first symptom leading to a brain tumor diagnosis in adults.

With continued growth, the tumor presses on normal tissue around it, causing dangerous intracranial pressure from swelling and/or a buildup of cerebrospinal fluid, liquid that lubricates the brain. Resulting symptoms will vary depending on the tumor’s size, type and where it’s located in the brain. But any of these symptoms is serious and requires immediate medical attention whether the cause turns out to be a brain tumor, a pseudo tumor, a stroke or something else:

• Progressive vision changes
• Personality changes
• Difficulty thinking, speaking, finding words
• Confusion or disorientation
• Weakness, numbness or loss of movement in one side of the body
• Balance problems or dizziness
• Sensory changes
• Severe, recurrent headache

Back to the Headache

Headache may indeed be a brain tumor symptom, but they are never a “once in a blue moon” event and are usually associated with other symptoms, including:

• Weight loss
• Vision changes
• Limb weakness or numbness/tingling
• Seizures
• Confusion
• Nausea/vomiting

The bad news: Brain tumors are a serious form of cancer with a relatively high fatality rate. The good news: They are extremely rare, and a one-off headache, even if it’s once-in-a-lifetime painful, does not indicate a brain tumor. It’s much more likely to be related to emotional stress, poor sleep, a skipped meal or something else that is likely reversible and treatable.