Brain Pain: Could it Be a Tumor, Aneurysm or Migraine?

Headache is one of the most frequent ailments there is. Most headaches are mild and resolve quickly, at worst making for a rough day at work or a bummer of a day off.

“The most common causes of various types of headaches aren’t related to anything serious like major structures or blood vessels,” neurological surgeon Nicholas C. Bambakidis, MD, says.

But sometimes headaches can signal a much more serious health problem – especially if they are sudden, severe or worsening over time, Dr. Bambakidis says.

Common Causes

How can you tell the difference between a common headache and when it may be be the sign of a serious condition?

The three kinds of common headaches are tension, cluster and migraine.

Tension headaches are comparatively mild and often feel like a tight band around the head.

Cluster headaches are usually more painful. They develop in patterns or clusters around the head, often on one side of the head and especially near the eye.

Migraines are the most severe of these three. These headaches are characterized by intense, pulsating pain and are often accompanied by nausea and extreme sensitivity to light. Migraines can last hours or days at time.

“These headaches can be treated with a variety of medications,”  Dr. Bambakidis says. “But migraines can be especially severe and complicated.”

If you think you may be suffering from recurring migraines, talk with your doctor about possible treatments.

Serious Conditions: Tumors and Aneurysms

Brain tumors are growths inside the skull or in the central spinal canal. Brain aneurysms are balloon-like swells of blood within cerebral arteries or veins that may rupture over time. Both of these are extremely serious health matters that need medical intervention – and both of these may cause headaches.

“If you have a headache that is new or unusual or accompanied by neurological symptoms like numbness or tingling in a limb, it may be a sign of a brain tumor,” Dr. Bambakidis says. “They tend to be worst in the morning and late in the day, and often occur with nausea and vomiting.”

Dr. Bambakidis points out, however, that not all patients with brain tumors experience headaches.

Patients with bleeding aneurysms may feel like they have “the worst headache of their life,” he says. These intense headaches often areaccompanied by a brief loss of consciousness.

When to See the Doctor

Seek medical care through a primary physician if you experience the gradual onset of headaches that worsen over time, Dr. Bambakidis says.

“Usually an office visit and a careful history is adequate to determine if any additional studies are warranted,” he says.

But if you feel like you have the worst headache of your life, or if your headache is accompanied by vomiting or the loss of consciousness, you should go to the emergency room.

People with a brain tumor or aneurysm require evaluation by a medical neurologist.

“Patients with brain tumors often require some kind of surgical procedure,” Dr. Bambakidis says, “and patients with aneurysms often need additional testing to look at the blood vessels in the brain.”

Nicholas C. Bambakidis, MD, is the Director of Cerebrovascular and Skull Base Surgery and Program Director of Neurological Surgery at University Hospitals Cleveland Medical Center.