Dr. Anne Damian Yacoub, co-director of the Johns Hopkins Headache Center and assistant professor of neurology at Johns Hopkins, said Newsweek“A headache is both a common symptom of multiple medical conditions, but also a diagnosis in itself. Any new type of headache should generally be at least discussed with your GP.”
Not all headaches require immediate medical attention, but some may be a sign of a more serious health problem, as seen in a viral post shared on Reddit. User TofuBoy22 said a headache he had for six months turned out to be a brain tumourwhich is an abnormal growth of tissue found inside the skull.
The Redditor said their headache started out mild but was “still in the same spot above the left eye and around the back of the head behind the left ear”.
They had an MRI, which showed a brain tumor and ‘after about a week I was quickly admitted to hospital [U.K.] National Hospital for Neurology and Neurosurgery in London where over the next 10 days I had two operations,” they said in an update shared in another Reddit Publish.
Brain tumors can be benign or malignant. The tumor receives a numerical score that reflects its malignancy rate. “This score can help doctors determine how to treat the tumor and predict the likely outcome, or prognosis, for the individual,” says the NINDS.
When does a headache require emergency medical attention?
The presence of certain conditions and symptoms suggests “the possibility that the headache is a symptom of a serious cause” and prompts more urgent evaluation, said Dr. Mark Malkin of the Rose Ella Burkhardt Brain Tumor and Neuro-Oncology Center. from the Cleveland Clinic, Told Newsweek.
These terms include, but are not limited to, the following, as stated by Yacoub and Malkin:
- Onset of headache in childhood, middle age or later.
- Recent onset and progressive evolution of the headache.
- A new headache after the age of 50 or in young children.
- Personal history of cancer or immunosuppression or headache in pregnant patients.
- A headache associated with symptoms (such as fevers, chills, night sweats, changes in weight, pain or numbness in the jaw when chewing).
- A headache associated with neurological or other general symptoms (such as numbness, tingling, weakness, loss of vision, double vision, seizures, vomiting, and excessive lethargy).
- A headache that reaches its maximum intensity in less than a minute.
Yacoub said: “It can be difficult for patients who have a long history of headaches to know when they should be reassessed. I would say that an increase in headache frequency or a change in the quality of headaches headache should prompt another visit to your doctor.”
Malkin said that for any of the aforementioned severe symptoms associated with headaches, you should see a neurologist who will assess the following issues:
- Does the headache not easily conform to a harmless pattern (like a tension headache or migraine)?
- Does the patient “look sick” or “not well”?
- Are there any abnormal signs on neurological or general examination?
- Are there signs of irritation of the meninges (the thin transparent covering of the brain)?
“Based on all of the above, an MRI [magnetic resonance imaging] brain or blood tests, may be indicated to more fully assess the situation,” Malkin said.
Should a benign brain tumor be removed?
Yacoub said brain tumors can either originate primarily from the brain or be a “metastasis [a malignant growth] another cancer elsewhere in the body.”
Malkin said: “Tumors that appear in the brain are rarely truly benign. Benign implies that once discovered it never grows, or once removed it never grows back.”
Yacoub said benign brain tumors are quite diverse, and determining whether a brain tumor should be removed depends on where the tumor is in the brain, as well as its potential for growth and spread.
The most common benign brain tumor is a “grade 1 meningioma,” which actually arises between the brain and the skull, rather than inside the brain itself, he said.
The vast majority of meningiomas occur spontaneously and we do not know the cause. “Rarely, prior exposure to ionizing radiation to the head (for example, to treat childhood leukemia) results in the development of a meningioma (or multiple meningiomas) years or even decades later,” Malkin noted.
Meningiomas don’t need to be removed if they’re small and “don’t cause symptoms, cause pressure in the brain, or grow larger over time,” he said.
When is a brain tumor life-threatening?
Malkin said there is “genuine cause for concern” if a brain tumor causes incessant symptoms, significant neurological signs, or if there is evidence on an MRI that it might be malignant (such as distortion of surrounding brain structures).
Yacoub said brain tumors can sometimes be life-threatening. Sometimes even benign tumors need to be removed because of the compression they cause on important brain structures. “These management decisions are usually made by a neurosurgeon or neuro-oncologist.”
Treatment decisions are made based on the type of tumor, how aggressive it is, as well as the location of the tumor, she said.
Malkin said treatment options for brain tumors include surgery, radiation therapy and drug therapy, including chemotherapy, non-chemo drug therapy and immunotherapy (either activation or suppression of the immune system).
For more information on headaches and brain tumors, see the National Institute of Neurological Disorders and Stroke website.
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