I have a headache. Is it a brain tumor?
Medically reviewed and written by Ashwin Malhotra, M.D. — July 10th, 2021
In this post I really just want to share the red flag symptoms that suggest a headache is more than just a headache.
In general, most patients presenting with headache are eventually found to have a primary headache disorder. The most common primary headache disorder encountered is overwhelmingly migraine.
Unfortunately, a large majority of patients with migraine do not receive an accurate diagnosis because of atypical presentations. In addition, the clinical features of migraine overlap with secondary causes of headache – the bad stuff (see stats below). This is where a careful history and a detailed physical exam are the key.
Specifically, a search for any red flag symptoms is number one and should prompt further diagnostic testing to uncover what’s causing the headache (i.e., the etiology). With this approach, if no red flags are present, further diagnostic testing is often not needed to investigate a secondary headache syndrome. And if a clear headache syndrome diagnostic criterion is met or recognized, treatment targeted to that headache syndrome can begin.
Must Know Red flags:
Fever, night sweats, chills, weight loss, jaw claudication
Cancer history, immunosuppression, chronic infection (human immunodeficiency virus [HIV], tuberculosis)
Confusion, new focal neurologic symptoms/signs, double vision, transient visual obscurations (e.g., blacking out or greying out of vision), pulsatile tinnitus
Thunderclap onset (i.e., severe, all of a sudden, sharp headache, like lightening)
New onset, non-stop/getting worse non-stop headache
Headache that worsens with change in position (laying vs standing, etc.)
New headache onset during pregnancy
Headache that is worse with cough, sneeze, bending, straining
Almost 3 billion people worldwide have a headache disorder. From that pool, approximately 1.89 billion have tension-type headaches and 1.04 billion have migraines.
And about 2% of those with headaches may have a secondary cause for the headaches. This is screened for by the red flags symptoms noted away. Not everyone in this small pool has a brain tumor, but that is one of the many possibilities.
Taken together, having a headache is unlikely to mean one has a brain tumor, but it is a possibility after many other less life-threatening possibilities.[/vc_column_text][/vc_column][/vc_row]