Headache Or Brain Tumour: Signs To Watch Out For And When To See A Doctor

Headaches are everyday problems for most of us caused from stress, dehydration, poor sleep and sometimes even that extra cup of tea. A brain tumour, by contrast, is a frightening thought and yet, clinically, the two can overlap. The good news: for the vast majority of people with headaches the cause is not a brain tumour. The tricky part is that tumours can cause headaches, and those headaches sometimes look like routine headaches at first. Below we discuss why the confusion happens and the concrete red flags that should prompt urgent medical review.

Why do headaches and brain tumours look alike?

Headaches are a symptom, not a diagnosis. Tumours cause headache when they irritate pain-sensitive structures or when they increase pressure inside the skull. That produces pain which is sometimes dull, sometimes throbbing and that overlaps with patterns seen in chronic tension headache or migraine. Studies and clinical reviews repeatedly emphasise that headache is one of the common symptoms in people with brain tumours, but it is rarely the only symptom and is often indistinguishable in quality from common primary headaches. Put simply: the symptom can be the same, the reason very different.

Large diagnostic-review studies show two important points:

• A substantial proportion of people with brain tumours report headaches at presentation but many people with brain tumours also have other symptoms. Isolated headache alone is an unreliable predictor of brain cancer.
• Since brain tumours are comparatively rare and primary headaches (like migraine, tension) are common, most new or changing headaches will still be benign. That's why clinicians use red flags and neurological signs to decide who needs brain imaging.

How to tell a routine headache from one that could be a tumour: the red flags

1. New headache in someone without a prior history especially if you are over age 50. A new pattern in later life is suspicious.
2. Progressive change like headaches that are steadily getting worse over days to weeks despite usual treatments.
3. Morning predominance or waking you from sleep particularly headaches that are worse on waking or come with nausea/vomiting.
4. Associated neurological signs like double vision, blurred vision, weakness or numbness on one side, slurred speech, coordination problems, sudden personality or memory changes. These focal signs point to a structural brain problem according to studies.
5. A new-onset seizure or fit in an adult is a red flag for intracranial pathology, including tumours.
6. Unexplained weight loss, fevers, or a prior history of cancer raises concern for secondary brain tumours.
7. Thunderclap or sudden severe headache while often associated with bleeding, a very sudden severe headache still requires immediate assessment.

What “green flags” or the reassuring signs look like

Doctors also look for signs that suggest a primary benign headache: long-standing pattern that responds to treatment, clear triggers (like menstruation, foods, dehydration), and no progressive features or focal neurological signs. Those features lower the likelihood of a tumour and usually don't prompt immediate imaging.

If red flags are present, clinicians commonly order brain imaging (usually an MRI; CT if MRI not immediately available) and a focused neurological exam. Evidence-based guidance stresses that not every headache needs a scan but imaging is indicated when clinical suspicion is raised by red flags or neurological findings. Many specialist and guideline reviews focus on refining these criteria so imaging is used where it changes management.

When to see a doctor

See your GP if you have a new kind of headache, a noticeable change in pattern, or a headache that's getting worse. Go to the emergency department or call emergency services for sudden severe headache, seizure, loss of consciousness, acute weakness, sudden vision loss or speech difficulty. If you have a history of cancer and a new or changing headache, seek rapid assessment.

Most headaches are not tumours. But tumours can cause headaches and other neurological signs and isolated headache rarely rules in or out a brain tumour. The practical approach is symptom pattern + red flags + focused exam. If you or someone you care for has a new, progressive, or neurologically accompanied headache, get it checked as early diagnosis improves options and outcomes.

Disclaimer: This content including advice provides generic information only. It is in no way a substitute for a qualified medical opinion. Always consult a specialist or your doctor for more information. NDTV does not claim responsibility for this information.

References

Update on headache and brain tumors, SAGE Journals, 2021.

Red and orange flags for secondary headaches in clinical practice, NIH, 2019.

Isolated headache is not a reliable indicator for brain cancer, NIH, 2021.

Brain tumours — symptoms and when to see a GP, NHS, 2023.

Imaging in headache disorders — indications and practice, NIH, 2022.