World Brain Tumour Day: One of the most frequent neurologic complaints in the world is headache. Although most headaches are harmless and may be associated with things like migraine, tension headache, stress, and lack of sleep, many people are concerned that headaches that persist for a long time may indicate a brain tumour. Headaches may occur with both conditions. On World Brain Tumour Day, we reached out to experts to understand the difference between a migraine and a brain tumour headache so that a timely diagnosis and treatment can be made.
Difference between migraine and brain tumour
“A migraine is a neurological condition in which the person suffers repeated attacks of moderate to severe headache, sometimes with visual problems (aura), sensitivity to light and sound, nausea and vomiting. Migraines are usually on one side of the head, but can be on both sides, and last from a few hours to days. Some patients can spot particular triggers that worsen their symptoms, such as stress, hormonal fluctuations, lack of sleep, dehydration, or some foods,” says Dr Praveen Gupta, Chairman, Marengo Asia International Institute of Neuro & Spine (MAIINS), Gurugram.
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Dr Gupta says, “Headaches due to a brain tumour, however, will usually result from the build-up of pressure inside the skull caused by the increasing mass. These headaches can be different to migraine in that they tend to be more frequent. Often they may be more persistent and may worsen over weeks and months and these may be more severe in the morning. Others experience exacerbation of pain when coughing, sneezing, bending, and doing activities which raise intracranial pressure.”
What are the symptoms of brain tumours?
There are a number of differences with regard to symptoms. Brain tumours can cause other neurological symptoms in addition to the classic symptom of migraine, which is usually nausea, visual disturbances, and sensitivity to light, depending on the tumour’s location. The symptoms may include seizures, weakness or numbness in an arm or leg, trouble speaking, balance problems, personality changes, memory problems, or vision problems that slowly worsen. If a headache develops for the first time with any of the above symptoms, it should never be ignored and should be promptly evaluated,” reveals Dr Gupta.
When does a headache need medical attention?
“Though the majority of headaches are what we call primary headaches, and are benign in nature, there are certain ‘red flags’ which may point towards a more serious underlying cause and must not be neglected. If a headache occurs in the setting of fever or other systemic or infectious symptoms or along with neurological deficits like vision disturbances, speech difficulty, limb paralysis, neck stiffness, etc,” says Dr Parul Dubey, Consultant, Neurology, Manipal Hospital, Goa.
Dr Gupta says, “Headache history and age is another factor of importance. People with a long history of migraines typically know how their migraine headaches usually occur. If the headache suddenly changes in the nature, frequency or severity, especially in adults over 50 years old, it should be a concern. Likewise, if someone who previously never had migraine starts having chronic headaches, it is wise for him to seek medical help.”
“Several ‘red flags’ to alert one to the need for immediate neurological consultation are described. These may involve headaches that awaken the person, increasingly severe headaches, headaches with convulsions, or a sudden drop in strength or co-ordination, confusion, visual changes, recurring vomiting or non-responsiveness to normal treatment. If these features are present, then diagnostic investigations such as MRI or CT scans may be recommended,” he reveals.
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Dr Gupta says, “Fortunately, there are some good things to note: the diagnosis of migraine and brain tumour are much more accurate than in the past, thanks to the advances in neuroimaging and neurological care. Early diagnosis is critical. Headaches will cause anxiety in patients but remember that most are not due to brain tumours. Headaches are also not usually the first or only symptom of a brain tumour and so it should be noted. Neurologic impairments, seizures or mental changes are often present with headaches. On the other hand there are millions of people worldwide with migraine who experience recurrent headaches, many, many more than those who have brain tumours.”
If headaches are recurring, worsen or cause abnormal neurological symptoms, it is important to get medical attention. A thorough clinical evaluation by a neurologist can help identify the underlying cause, provide reassurance when appropriate, and ensure timely treatment when necessary.
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(This article is meant for informational purposes only and must not be considered a substitute for advice provided by qualified medical professionals. Always seek the advice of your doctor with any questions about any medical conditions.
