Is a Headache a Sign of a Brain Tumor?

This page is for anyone worried that a headache could mean a brain tumor. It explains the patterns doctors watch for, the far more common causes, and when to get help.

No, not usually. Headaches are common. MedlinePlus says serious causes are rare, and a brain tumor is one of them. Most headaches come from tension, migraine, or a minor illness.

The National Cancer Institute lists two headache patterns to check with a doctor. One is a morning headache. The other is a headache that goes away after vomiting. NCI says signs depend on where the tumor is, what that part of the brain controls, and the size of the tumor.

NCI lists other brain tumor signs to check with a doctor. These include:

• Seizures.
• Vision, hearing, and speech problems.
• Loss of balance and trouble walking.
• Weakness.
• Changes in personality, mood, or the ability to focus.
• Frequent nausea and vomiting.
• Loss of appetite.
• Unusual sleepiness.

NCI says these signs can also be caused by other conditions.

MedlinePlus says tension headache is the most common type. It is linked to tight muscles in the shoulders, neck, scalp, and jaw, and can be related to stress. Migraines cause throbbing pain, often with nausea or sensitivity to light. Lack of sleep, caffeine withdrawal, and alcohol can trigger migraine. Taking pain medicine more than 3 days a week can cause rebound headaches. Headaches can also come with a cold, the flu, or a fever.

Your doctor asks how long you have had headaches and whether this one feels different from your usual pattern. They also ask about any other new symptoms. A neurological exam checks your mental status, coordination, walking, muscles, senses, and reflexes. If your history and exam raise concern, the next step is an MRI, a scan that uses magnets and radio waves to create detailed pictures of the brain. If the MRI shows something that needs a closer look, a biopsy may follow, taking a small tissue sample to check under a microscope. Ask the team performing it when the report should be ready.

A normal exam does not end your care. If a headache keeps getting worse, or new symptoms appear, tell your care team again.

• Call 911 or go to an emergency department if a headache comes on suddenly and is explosive, violent, or the worst you have ever had. Go too if you have a seizure, or if the headache comes with slurred speech, loss of vision, weakness or trouble moving an arm or leg, loss of balance, confusion, or memory loss. Do not drive yourself.
• Call your care team right away if a headache gets worse over 24 hours, comes with a fever and stiff neck, follows a head injury, is severe in one eye with redness, or is the first headache you have ever had and gets in the way of daily life. MedlinePlus says the same for anyone who just started getting headaches, especially after age 50. Call right away too if you have a history of cancer, or a weakened immune system from chemotherapy or steroids, and you get a new headache. If you are on chemotherapy, call day or night.
• Call your care team the same day if the pain is worse in the morning or eases only after you vomit. NCI lists a morning headache, or one that goes away after vomiting, as a brain tumor sign. Call the same day too if your usual headaches change in pattern, or you notice trouble with balance, a change in hearing, or a shift in mood or focus. NCI lists these as signs to check.

• My headaches follow this pattern [describe] — is that worth investigating?
• Could this be migraine or tension rather than something serious?
• Are there any other symptoms I should watch for?
• Do I need any imaging, or can we watch and wait?

• National Cancer Institute — Adult Central Nervous System Tumors Treatment (PDQ)
• MedlinePlus — Headache