We asked neuro-oncologists Lakshmi Nayak, MD, and Eudocia Quant Lee, MD, MPH, from Dana-Farber Cancer Institute’s Center for Neuro-Oncology, to review the red flags that warrant a medical follow up:
- Headaches that are new or worsening, especially in a person who doesn’t normally have headaches. Often they are worse when lying down and in the morning, or wake someone from sleep. They may include nausea or vomiting.
- New and persistent loss of balance or difficulty walking.
- A seizure or loss of ability to speak; double or blurred vision or vision loss; hearing problems. Gradually worsening weakness or loss of sensation in an arm or leg.
- Personality changes such as emotional withdrawal or anger, or becoming easily confused.
The takeaway message, Nayak says, is that “new-onset headaches requiring medical assistance in an adult without prior history of headaches, change in quality or severity of headaches, in conjunction with new visual problems — these would worry me. If someone says it’s the worst headache of their life, I would be suspicious. Also, if the headaches occur in someone who has an active cancer, those should be investigated further.”
Some brain tumor symptoms may mimic symptoms of migraine headaches, Nayak notes, “so that can be a tricky situation.” However, most migraine patients have had the problem since childhood and are familiar with the headaches.
A stroke can also cause similar symptoms, but usually a stroke happens suddenly and without warning, while signs of a brain tumor appear more gradually.
Room spinning dizziness is a not a common brain tumor symptom and is more often related to an inner ear problem.
To rule out or diagnose a brain tumor, a person will undergo a neurological exam to test vision, hearing, balance, reflexes, arm and leg strength, and coordination. A CT or MRI scan is commonly used to image the brain for evidence of a tumor.
This information should be reassuring for people who fear the worst when they have a bad headache, because brain tumors are very uncommon. But if your symptoms resemble those listed above, see your doctor.
This article was originally published in 2013 and was medically reviewed again in 2019 for accuracy.