When Is a Headache a Symptom of a Brain Tumor? Very Rarely

man with headache

Headaches can be debilitating, but they are rarely the sign of a brain tumor.

Updated June 20, 2022

A bad headache can be a frightening experience. But sometimes, even scarier than the pounding in your head can be the tricks your mind plays on you as it’s happening.

When that throbbing pain gets unbearable, it’s easy to worry that your headache might be something more serious, like a brain tumor. But headaches are very common and brain tumors are very rare, says Lauren Schaff, a neuro-oncologist at Memorial Sloan Kettering Cancer Center (MSK).

“Everybody gets headaches at some point,” says Dr. Schaff, who practices at MSK in Manhattan as well as MSK Bergen in Montvale, New Jersey. “A brain tumor is not going to present with one single headache that lasts for a couple of hours and never comes back. Also, many people suffer from primary headache disorders where they experience frequent headaches.”

She gets concerned “when there’s a new type of severe headache that’s worsening in frequency or intensity, especially if it is accompanied by other neurological symptoms.”

Dr. Schaff says if you’re experiencing worrisome headaches, you should seek medical advice — not necessarily because they’re being caused by a brain tumor, but because getting to the root of the issue can help you feel better faster. For example, both brain tumors and migraine headaches — which are much, much more common — can cause nausea and vomiting that can be managed with medication.

Memorial Sloan Kettering neuro-oncologist Lauren Schaff

Lauren Schaff

What are the warning signs of a brain tumor?

If you visit a neurologist, they may recommend getting an MRI, which uses radio waves and a powerful magnet to create detailed photos of areas inside the body. However, plenty of patients with headaches do not even need imaging, Dr. Schaff says. She can usually determine if a person’s headache warrants a closer look with an MRI by considering the following criteria:

Your headache comes with other symptoms.

Because our brains control everything in our bodies — from our speech to how we walk to our memory and our emotions — a headache from a brain tumor is often accompanied by other neurological symptoms, like:

  • Feeling disoriented.
  • Having trouble speaking or understanding others.
  • Walking with difficulty, like dragging a leg or keeping your feet very far apart.
  • Feeling numb or weak on one side of the body.
  • Not being able to follow simple commands, like “Touch your nose” or “Hold up three fingers.”

Of course, having a word on the tip of your tongue or forgetting where you put your keys is also part of being human. But Dr. Schaff says when the problems get worse, she gets more concerned.

“A lot of times, I see patients who have had headaches for a few weeks that they’ve been kind of been ignoring,” Dr. Schaff says. But then something tips her off that there may be more to it: “Their caregiver says, ‘Oh yeah, Mom’s had a lot of trouble finding words and hasn’t been able to read as well. We just thought she needed new glasses.’ ”

If the difficulties are only temporary, Dr. Schaff says, that’s reassuring.

Your headache is worse when you lie flat.

A headache that feels different from others you’ve had in the past is worth checking out, especially if it changes when you move positions. “One of the things that causes headaches is a buildup of pressure,” Dr. Schaff says. “So if you have a brain tumor and you’re lying flat all night, the pressure is going to be higher than it would be when you’re sitting upright.” However, she says, 99% of the time, a headache in the morning has another cause, like sleep apnea. Dr. Schaff says to look out for a headache that wakes you up; headaches that build over the course of the day are usually less serious.

Your headache gets progressively worse over days or weeks.

Some headaches come and go. Some can last for a few days. But headaches that keep coming back stronger are worth a call to the doctor.

You have a seizure, even if it isn’t a full-body one.

A general, full-body seizure is characterized by a person falling to the floor and convulsing. It means the whole brain is having a seizure. But if only part of the brain is having a seizure, the symptoms will be related to that area of the body that the brain controls. There might be shaking or uncontrollable movements of just one arm, for example.

How MSK Experts Diagnose and Treat Brain Tumors

In the very unlikely event that a headache does lead to a brain tumor diagnosis, experts at MSK are ready to help. Specialists from all areas of brain tumor care will design a treatment plan especially for you.

Bringing together experts in surgery, chemotherapy, radiation therapy, and quality-of-life issues helps us ensure that we choose the combination of therapies that will most effectively treat the tumor and provide you with the best outcome possible.

At MSK, we offer many more brain tumor treatment options than previously existed and numerous opportunities for people to participate in clinical trials. To make an appointment, call 800-525-2225.