So You Have a Headache - What If it is a Brain Tumor Headache?

The fear of brain tumor headaches is what drivesheadaches they might require further workup. Red
many patients to their primary care doctor or to aflags include headaches that worsen with coughing,
headache clinic. Most times they present to the officesneezing or bending over. Any weakness is a concern
afraid of their symptoms and convinced they mayas are visual changes, memory and personality
have a brain tumor. Believe it or not, clinicians do takechanges.
this seriously but it is dependent on the patient'sCertain things put people at risk for tumors in the
symptoms and the results of the physical exam.brain. These include:
When a headache does occur from a brain tumor it is- smoking
termed a secondary headache because some other- previous history of breast, prostate, lung or neck
medical problem is causing the pain. This is also knowncancer
as an organic headache. Brain tumors are rare, even- smoking
in people with recurring headache. When they do- smoking (get it?)
occur about 50% of the patients present withNeuroimaging In Brain Tumor Headaches
headache, and many will also have seizures and otherMore often than not, headache is not the complaint
neurological problems such as memory loss andthat leads to a tumor. Most patients present with
personality changes.other neurological symptoms described above. I
Brain Tumors vs Other Headachesshould note that the symptoms can also include
Typical brain tumor headaches may have pain all overdizziness, tinnitus and incontinence. When an exam is
the head that is throbbing in nature. The headacheabnormal and a patient has visual defects or
may be mild in the morning and then progress andweakness then either a CT or MRI of the brain is
worsen during the day. They may also worsen overneeded. Contrast MUST be given as parts of a tumor
a period of months. Some people have had migrainewill appear different on imaging when contrast is
type symptoms with tumors. Some types of tumorspresent. After imaging, the doctor may have to do a
may obstruct cerebrospinal fluid which results in alumbar puncture or spinal tap if the results of the
headache that is positional..it is relieved when theimaging warrant this.
person lays down.Treatment Of Brain Tumors and the Headache
This is different from other headaches such asTreatment of tumors is directly related to the type
tension and migraine which are considered primaryof tumor. Some need surgery, some need
headaches (no underlying medical problem). Tensionchemotherapy and radiation and sometimes, with
and migraine headaches tend to be throbbing andbenign tumors they are just watched for awhile. This
pulsating headaches and are generally not all over themeans serial MRI's every couple of months. The
head.headaches are treated symptomatically and generally
At times, symptoms and complaints from patientsrespond well to steroids or anti-inflammatories. Many
may alert a doctor and these are called "red flags".times the brain tumor headaches disappear after
Although they can happen with migraines and tensionsurgery.