Are your symptoms due to a brain tumor or migraine?
In the US there are around 700,000 people living with a brain tumor compared to 37,000,000 people living with migraine. (1,2) Yet the symptoms are similar and easily confused. They are so similar in fact that many people with their first migraine are rushed to hospital fearing the worst.
If you experience a sudden attack where you experience pins and needles, blurred vision, colored spots and patterns, cognitive impairment, memory loss, slurred speech or even difficulty walking it will cause serious concern. Combine all this with a skull-crushing headache and it’s understandable why you might rush to the hospital.
When are symptoms like this a sign of something life threatening like a brain tumor or from something else like a migraine?
Let’s look first at brain tumors.
What are brain tumors?
A brain tumor occurs when abnormal cells form in the brain. In a healthy brain, cells follow a normal cycle of aging, death, and replacement by new cells. With tumors, this process is interrupted. (3)
The tumor cells continue to grow without dying even though the body doesn’t need them. As the tumor grows it takes up space within the skull and interferes with normal brain activity.
Tumors can cause damage by:
- Increasing pressure in the brain.
- Shifting the brain and causing it to push against the skull.
- Invading and damaging nearby healthy brain tissue and nerves.
Brain tumors can be benign or malignant (brain cancer).
Benign tumors are non cancerous. They are typically slow-growing and have clear borders which separate them from healthy brain tissue. Spreading is rare. Benign tumors may be found in areas of the brain which control vital life functions and may still require urgent treatment. Around 60% of brain tumors are benign. (4)
A malignant brain tumor is a cancerous tumor in the brain. Brain cancer is the same as a malignant brain tumor. These are often life-threatening tumors which grow rapidly and aggressively spread to surrounding areas in the brain and central nervous system. Less than 40% of brain tumors are found to be malignant. (4)
Brain Tumor Symptoms
Symptoms of a brain tumor can vary depending on the type of tumor and its location. Different areas of the brain are responsible for different functions of the body. The location of the tumor often affects the type of symptoms experienced.
The onset of symptoms also vary. Some tumors may have no symptoms until they are large which then led to a serious and rapid decline in health. Others may have a slow, gradual onset of symptoms over time.
What makes tumors challenging to separate from other headache disorders such as migraine is the similarity of symptoms. Most headaches are not associated with brain tumors. But, headaches are one of the most common symptoms experienced by those with brain tumors. See below chart (5) for how common certain symptoms are in those with brain tumors.
Common symptoms of a brain tumor
List of brain tumor symptoms:
- headache or migraines
- nausea and/or vomiting
- reduced cognition and mental faculty
- difficulty speaking or remembering words
- short-term memory problems
- changes in vision, hearing, smell or taste,
- loss of consciousness
- moodiness, irritability, depression or personality changes (which may only be noticed by friends or family)
- balance problems
- weakness in one part of the body
If you’ve had migraine for a while then you probably noticed that just about all these symptoms can be experienced with a primary migraine condition.
This is why getting an accurate diagnosis is important. You may need to be referred to a neurologist who specializes in this area.
In a patient who passes a normal neurological exam with no other complaints except for a recurring headache, the diagnosis is rarely a brain tumor. Below are a number of symptoms that have been identified as ‘red flags’ that may indicate something more serious.(1)
Chart Reference: Prestegaard, AR. ‘Is This A Brain Tumor That Hurts’. Michigan Headache & Neurological Institute. Accessed 28 Jul 2015.
The cause of brain tumors is not fully understood. Researchers globally are investigating potential causes. It is understood that certain inherited conditions or genetic mutations are linked with brain tumors. These include multiple endocrine neoplasia, Von Hippel-Lindau disease and neurofibromatosis type 2. (11)
Mobile phones have not been shown to cause cancer or more specifically brain cancer. Current evidence is very weak. (12) Despite over a decade of widespread mobile usage globally, there has been no upward trend observed in brain cancer incidence rates. (13)
If it’s migraine, get the next most important steps you need to control your condition before it get’s worse.
Diagnosing brain tumors
What you can expect from your visit with the doctor is a series of questions about your symptoms as well as your personal and family health history.
Often a physical exam will be performed which includes a neurological exam. If there is reason to suspect a brain tumor, the doctor may request one or more of the following (6)
- CT (CAT) or MRI scan to see detailed images of the brain.
- Angiogram or MRA which involve the use of dye and x-rays of blood vessels in the brain to look for abnormalities.
- A biopsy may be also be performed. This is when a tissue sample of the tumor is taken often through surgery or needle and sent to the lab to test for any signs of cancer.
Treating brain tumors
If a brain tumor is discovered, surgery is usually the first option to remove it. However, sometimes the brain tumor cannot be surgically removed because of its location in the brain.
In this case, chemotherapy and radiation therapy are both options for killing and shrinking the tumor. These options may also be used after surgery to kill any remaining cancer cells.
For tumors located deep in the brain, Gamma Knife therapy may be used which is a relatively new form of highly focused radiation therapy. (7)
Treatments for cancer can also damage healthy tissues so it’s important to discuss all your options with your doctor. Knowing the possible side effects, long term consequences and risks are important in making an informed decision.
The odds: migraine vs brain tumor
Migraines are common. They are more common than asthma and epilepsy combined. They simply don’t get the same advocacy or support. Around 15% of the population or 37 million people in the US experience migraine. Globally around 1 in 7 people will experience migraine at some point.
Brain tumors, on the other hand, are rare. Just 0.2% of the population are living with a brain tumor diagnosis. There are around 70,000 new cases of any type of brain tumor being diagnosed each year in US. (8) That’s a 0.02% of the population. In other words, statically speaking, there is a 99.8% chance that you are tumor free.
My philosophy is that it’s better to be safe than sorry. If in doubt or if you’re worried then see your doctor.
Brain tumors can be benign or malignant. In both cases waiting longer only lets things get worse. Make an appointment and get a professional diagnosis from a medical doctor.
Often the steps required to rule out a brain tumor are relatively simple. One or two consultations with the appropriate doctor and a scan may be all that’s required to rule out a tumor.
If your examination returns normal and you’re experiencing symptoms that resemble a tumor, then chances are you have migraine. Your doctor should be able to confirm this with you once tumors have been ruled out.
The good news is that migraines are rarely life-threatening. You may be surprised to know that around half the population with migraine haven’t actually been diagnosed. (9)
In addition to being notoriously under diagnosed, migraines are under treated and generally poorly managed according to a report from the World Health Organisation. (10) This means that for a segment of people with migraine it may go on to have significant impact for years and even decades.
Getting quality care, treatment and support is essential to control migraine.
Do you know anyone that has had a brain tumor or have you thought you might have a brain tumor?
The right next steps are not something you learn without years of experience, failure, case studies and best practices. Don’t let your migraine condition get worse. For a limited time, we are emailing this one-page checklist to every reader.
1) American Brain Tumor Association ‘Brain Tumor Statistics’. Accessed 28 Jul 2015.
2) Eross, Eric, David Dodick, and Michael Eross. “The sinus, allergy and migraine study (SAMS).” Headache: The Journal of Head and Face Pain 47.2 (2007): 213-224.
3)”General Information About Adult Brain Tumors”. NCI. 2014-04-14. Retrieved 8 June 2014.
4) CBTRUS Statistical Report (2012)
5) The Musella Foundation For Brain Tumor Research & Information. Patient Survey n=400.
6) Herholz K, Langen KJ, Schiepers C, Mountz JM (November 2012). “Brain tumors”. Semin Nucl Med 42 (6): 356–70. doi:10.1053/j.semnuclmed.2012.06.001. PMC 3925448. PMID 23026359.
7) GBM Guide – MGH Brain Tumor Center”. Brain.mgh.harvard.edu. Retrieved 17 February 2012.
8) American Brain Tumor Association. ‘Brain Tumor Statistics’. Accessed 28 Jul 2015.
9) Lipton, Richard B., et al. “Migraine diagnosis and treatment: results from the American Migraine Study II.” Headache: The Journal of Head and Face Pain 41.7 (2001): 638-645.
10) World Health Organisation. Lifting the Burden. ‘Atlas of headache disorders and resources in the world 2011.’ WHO Press. 2011.
11) Kleihues P, Ohgaki H, et.al. “Type and frequency of p53 mutations in tumors of the nervous system and its coverings”. Molecular Neuro-oncology and Its Impact on the Clinical Management of Brain Tumors. Recent results in cancer research 135. 1994. Springer. pp. 25–31. ISBN 3540573518.
12) Frei P, Poulsen AH, et.al. “Use of mobile phones and risk of brain tumours: update of Danish cohort study.” BMJ (Clinical research ed.) 343: d6387. 19 October 2011. doi:10.1136/bmj.d6387.
13) ‘Brain Tumours- Cancer’. Better Health Channel. Victorian State Government Fact Sheet. Accessed 28 Jul 2015.
Thank you Carl. I have suffered from Migraines since I was in elementary school (I am now 41). As a teenager, I began to have fainting spells (nausea, getting very hot, tunnel vision, then black out). When I was 27 I had a fainting spell in front of my finace (now husband). He encouraged me to go to the doctors. Doctors ran many blood tests (Thyroid, Diabetes, Anemia). Next step was a Nerologist. He sent me for an MRI. a few hours laters I got the call at work that I had a tumour and needed to see a Nerosurgeon right away. Very scary as I had to go myself.
The tumour they found was in my right temporal lobe near my perferrial vision. It was in between the size of an egg and walnut. It was a slow growing. After a few more tests and another MRI, I had it removed. Except for a post surgical grand mal seizure a few months later, my recovery went well.
The kicker is they said my tumour, a ganglioglioma, (which thankfully was benign) was not even the cause of my Migraines. So in the end, tumour gone, Fainting spells gone, Migraines not so much.
Hi Erica, that situation you describe where your symptoms changed with fainting spells was an important clue. Any sudden changes is something to speak to a doctor about. I’m glad your husband recommended a visit to the doctor and things turned out ok. It is very possible to have migraines and a tumor as your case shows. Thank you for sharing.
Hi my name is Sandra and i have been suffering with migraines since i was 7 years old and my aunt was diagnosed with brain cancer and she passed away 2 weeks later and could it happen to me?is that subject to talk to my neurologist about?thank you for answering my questions about this
Hi Sandra, there has been no link established between migraine and brain cancer or any brain disease. Having said that, in very rare cases, some people think they are having a migraine when it could be a brain tumor. See this article for more details on how to tell the difference: Brain Tumor or Migraine? The Remarkable Similarities That Catch Many By Surprise.
Thank you for this very informative article. I went to an ENT for pressure type headaches, which seemed to be affected by changes in the weather. I was also having more vision and hormonal problems. He sent me to a neurologist who ordered an MRI. They found a benign pituitary macroadenoma and a large pineal cyst. I had the pituitary tumor removed using endoscopic surgery as it was compressing the optic nerve. I am very happy that it was gone, but when I woke up after surgery they said that it wasn’t the cause of my migraines and I would keep getting them. Like the previous poster, I still battle with migraines but at least the other symptoms are gone.
I’m glad you discovered the tumour and it was safely removed. When a symptoms of a potential tumor are is ignored or delayed by a patient, that’s when it can become very dangerous. Thank you for your note Lisa, it’s important others see that.
I have been getting the aura which last anywhere from 10-30 mins. I don’t get the migraine headache.
I have not had them for a long time now they are quite frequent.
Whay can I do to prevent this happening?
I am 70 yrs old.
If you only experience the migraine aura without the headache it is still treated like a migraine. You might focus less on pain prevention and more on attack prevention and employ several tactics to manage your attacks. For more information about migraine auras visit: https://migrainepal.com/migraine-with-aura/
I have migraines for more than 20 years now. But, last week I had severe headache with stiffness in neck which lasted for 3-4 days. I was on complete rest (sleep), but it felt no better. Visited a Neuro who has prescribed a CT scan. I also have stretch in right shoulder joint and right leg. Is it something serious? I have appointment for CT scan this weekend. Do I need to worry?
I’m not a doctor so I cannot say unfortunately.
If other parts of the body are involved it would be important to address those to help improve your condition. It was good that you saw the doctor when your symptoms change.
I hope you improve soon.
I had a relative that mistook 2 brain tumors for migraines. She finally went to the ER when the pain became unbearable and a scan revealed an orange-sized tumor on one lobe and a golf ball-sized tumor on the other lobe. She was given 6 months- 1 year to live without surgery, 1-2 years with it. She never ended up even getting to decide as she died a couple days later.
There’s been a push to minimise the number of unnecessary scans by the medical community. If it was me or my family and there was reason to suspect something, I’d get checked. I hope this at least makes more people aware.
Thank you for sharing what must have been very difficult Elizabeth.
That is informative. I have had migraines ever since I was 12, am now 70. I thought they would go after menopause but that wasn’t the case. I had a friend who suffered migraine attacks but it turned out that her last attack was actually an aneurism in her brain and she had emergency surgery. What are the symptomatic differences between brain aneurism and migraine?
That’s a topic for a whole new article and something a neurologist can answer better than myself.
The key is if you notice any sudden or significant changes…. then it’s a good idea to see your doctor. Particularly if things typically follow a pattern.
I hope that helps Jan.
Thanks for the article. One question I have is whether a migraine abortive such as any of the triptans would be effective on headache related to a brain tumor? In other words, if the abortive triptan works on the headache, is that a good indication its not a brain tumor?
Interesting question Adam,
If a triptan works on the headache is that a good indication of a brain tumor – my unqualified guess is no. Why?
Several triptans don’t work for me personally. Does that mean I have brain tumor? Not necessarily. Many don’t work for a reasonable percentage of people of with migraine.
Another point to mention is, if the triptan did work for me, then stopped working, does that mean tumor? Again no, not necessarily. It could be a sign of something else such as medication overuse headache, rather than tumor. Sometimes treatments become less effective over time and other reasons.
So unfortunately it’s not that straightforward.
Thanks Carl. But to be clear, my question was really the opposite. If the triptan works is that a good indication it is NOT a brain tumor? I assume the answer is still that it is not straightforward. I look forward to your future installments.
Yes sorry, you’re correct Adam. My reply was written incorrectly. It should say "If a triptan works on headache is that a good indication it’s not a brain tumor."
Thank you for picking that up!
I am seeing the neurologist for the first time in a few days. I’ve had migraines and cluster headaches for years. However, they frequency and intensity have increased. I started recording the frequency 31 days ago and I’ve had 28 migraine days in that time. My head still hurt the other 3 but not enough for me to record it as a migraine. New symptoms have started this past month as well, dizziness, non stop nausea, blurry vision when my head hurts, some confusion or difficulties getting my thoughts straight, light sensitivity at all times. I’ve tried several meds but since they don’t work I no longer take them. They wanted me to have a cat scan immediately but my insurance wouldn’t approve it until I see the neurologist first. They said I could go to the Er but I could end up paying full price for everything. I wasn’t worried at first but everyone I know keeps asking if I’ve been checked for a brain tumor. I feel slightly better seeing the statistics but still nervous. Anything that I should specifically ask from the neurologist? I do have a history of cervical cancer almost 5 years ago.
Hi Marie, hopefully you’ve already seen the neurologist and they’ve determined if an MRI scan was necessary or not. If you haven’t gone in yet. Simply think about what you’d like to know. Get an understanding of expectations and timings regarding the scan and next steps. I usually find that helpful and reassuring. Hopefully everything will be all clear, but always best to be safe than sorry.
Hey Carl, I’m on google as a 14 year old girl, I have migraines that never go away, debilitating in in a nutshell. They only usually effect the left side of my head, but paired with that comes numbness to my left arm, nausea and waking up early in the morning (way out of my sleeping pattern) to a pounding migraine, I told my mum and she took me to the GP. We waited 3 weeks for an appointment and all this doctor said was ‘keep doing what you’re doing’ I was very angry to say the least, he prescribed me ‘the pill’ to regulate my hormones incase it was that, no luck. He said to have a CT scan, but in 6 weeks?!!? I get hospitals are busy but if it is something bad, they’ve let 6 weeks fly by with no help. I’ve tried 5 different paracetamol, anadin extra, ibuprofen and yet nothing even soothes my aches. If I rest my eyes my vision goes horribly blurry and doubled, I have to use all my mite to keep my eyes focused. Does my in-depth description give you an insight of whether this is a typical migraine case or something more sinister?? Please get back to me
Hi Jane, I’m glad your doing some research of your own and taking the initative. This is an important part of your own self care.
You should know that I’m not a doctor or medical professional. I’m simply someone with migraine. Brain tumor’s are rare and with the information in the article you should get some hints or questions to ask your doctor, but only your doctor can give you a medical diagnosis. The overwhelming likelihood is that someone has a migraine versus a brain tumor. If your doctor was urgently concerned they tend to expedite your precautionary scans and tests.
I hope that helps Jane. Best wishes.
I’m on here as a 14 year old. this morning I woke up with a splitting headache and very blurry vision in my left eye. my left eye has been getting blurry on and off for the past two to three weeks but never anything this bad. my left foot has only been tingling fairly frequently but I don’t know if that has to do with anything because I recently sprained my leg along the tibial shaft. I also had zero balance today and couldn’t stand up for more than 5 seconds at a time without support or swaying and almost falling. the loss of balance particularly progressed as the day went on. I’ve also been very tired and weak recently, particularly in my left leg, but then again it could have just been from my MCL tear early october and my sprain a few weeks ago. A lot of the time I feel as though I might pass out. do you think this might be from overtiredness (I just got off of soccer and crosscountry) or could there be another underlying problem?
I’m a patient with migraine who reads scientific journals and goes to medical events, but I’m not a doctor. I’d advise you get your parents to book an appointment to minimize the time you spend injuried and unwell so you can get back to your sports! They are great for your long term health and wellbeing. All the best!
I have always had migraines & have seen several neurologists with the same dianosis a small prneal tumor in front of optic nerve. Recently I saw another doctor who says tumor in in middle of brain & I might have to have surgery which would be difficult.. How can 3 doctors all say one thing & he says something entirely different.
Unfortunately, that is more common than you think. The hard part is knowing which doctor to trust and continue with. Quantity is not necessarily quality. Particularly if the latest doctor is a specialist in the field you might put more weight into his experience and expertise.
i’m 21 years old and i found out i have a Arachnoid cyst on the left side of my brain right under my temple. i was diagnosed with it at 19 but i was also diagnosed with chronic migraines at 14 . since then my migraines just randomly come and go. i was always told by neurologist to pay attention to triggers and avoid them. so i went ahead and assumed it was bright lights, i was wrong. when i wake up before 6 am i get a migraine. if i don’t drive with sun glasses. i drink grape soda or wash my face with a organic lavender product. don’t get me wrong sometimes it helps but over the years my migraines got longer an hurt more. i got my daith pierced on the right side and i still get migraines. doctor immediately said no brain surgery because i was born with it but never realized that was the reason i was always tired an my muscles felt weak and i randomly vomited. i never spoke about it an how i was bullied my whole junior high life because of the way my head was shaped but now i know what it was so im ok now 🙂
Hi Eva, I’m glad to hear you are doing better. Migraine can progress and get worse if we are not careful and not working with our doctor. There are other factors that can play a role like quality sleep, diet, exercise and stress management skills in addition to preventive treatments that can be prescribed by your doctor.
I am 49 years old and I have lived with migraines since I was 11.
They were worse in my teens and gradually got better in my 20’s and 30’s and early 40’s. The last 2 years they have got increasingly worse. I thought maybe it was hormonal but my levels are fine.
I have recently been going to see a neck specialist, since January but I’m not finding much success with this as I’m still getting the migraines.
One thing that has been different is that my hearing has changed. I have been to the dr about this and also a hearing specialist but all he did was look into my ear, no extra tests etc. There’s a constant buzzing in my ears and often if there’s a loud noise my right ear clicks.
Could this be related to my migraines or something else? Should I request a brain scan from my GP?
Hi Lisa, I’m not a doctor so I cannot provide medical advice. Migraine is known to change over time. If the changes are sudden then that is certainly cause for further tests to rule out worst case scenarios. Generally speaking, if the symptoms have had a gradually onset over time, then it is most likely migraine. Best option is to discuss further with your doctor. Migraine is known to be associated with tinnitus and vestibular symptoms. I hope that helps Lisa.
So I’m still a teenager and I know you aren’t a doctor but I’m wondering in I need one. For the past several years I have had the occasional visual aura with a plain old annoying headache, no actual migraine like pain. They started increasing all of a sudden and happened first once a month then once a week. Then they stopped for several months. Just the other night I had one which was different since they usually don’t happen at night. I went to bed but I was looking at my phone for possible info when I found it difficult to understand what I was reading. I kept messing up words and almost gabbing dyslexia like symptoms. I freaked out and went to go talk to my mom and while we were talking and looking stuff up it sometimes took me a minute or two to comprehend a sentence. After a little while it got better but I’m worried its going to happen again and I’m really not sure if this is “normal”. Any advice you have would be great, thanks!
Oh yeah, and I thought I’d add that medicine doesn’t normally help and it goes away after a while but always comes back at some point.
Hi Amber, migraine with aura is common. The symptoms you expressed are considered to be typical i.e. normal. For more information about it see this article and read the comments for other people’s experience: https://migrainepal.com/migraine-with-aura/
You should see a doctor. Especially if the medication you are currently taking is not effective. Tell them that. If you don’t get good results from the doctor after a few attempts I’d recommend a specialist.
What determines your attacks is your environmental factors and genes. Staying up a night, reading your phone in bed. Particularly when lying down with your head on your pillow is a big trigger for me personally, so I’m not surprised it is also a trigger for you. Keep a migraine diary to better understand your triggers (see Migraine Buddy or N=1 Headache). And do things that keep the brain happy and healthy. I.e. regular quality sleep, good food, exercise, hydration etc. I hope this helps. Good luck!
Hi Carl, your article was comforting. I’m 52 and recently started having vertigo. It’s much worse at night. I’ve always had migraines, but they are easily controlled with medication. I saw an ENT and she suspects vestibular migraines. She ordered a VNG test and a brain MRI with contrast. I’m waiting to have these tests, but in the interim, I’ve been terrified that it might be a brain tumor. I’m taking Meclizine, but it’s not helping much. Thank you.
Hi Kristina, I’m glad this article helped and that you are working with your doctor. Migraine is known to evolve over time and to express symptoms like vertigo more prominently versus head pain in older adults. Gradual changes generally are harmless but it is always good to check with the doctor for anything you are not sure about. If it is vertigo there is some helpful information here: Vertigo & Vestibular Migraine: A Balancing Act
Im a 13 year old girl. I have been experiencing daily headaches for 4 years now and medicine doesnt help at all. I have tried to sleep in a dark room and get a head massaged but nothing worked. I have tried four types of medicine but none worked. I have not been experiencing symptoms of a migraine but most of the symptoms of a brain tumor and more severe things. When i change positions (sit-stand) my head hurts more and im very sensitive to lights and sound. My behaviour has changed weirdly and i sometimes experience nausea. I have been having mood swings alot and for these past couple if days i have had a stiff neck. The type of headache changes everyday and it is continuous. I wake up and go to sleep with a headache everyday. I have also been experiencing vertigo for a bit and i had an MRI scan but it came out clean. I have to visit a neurologist soon, what should i expect at a first neurologist visit?
Hi Nisa, I’m glad to hear that you are seeing a neurologist. High and low-pressure headache is associated with pain changing according to different positions. You might like to mention this to your neurologist but hopefully, they consider this option with you. The first consultation with likely involve lots of questions and perhaps a physical exam. Then hopefully they will be able to diagnose and begin a treatment strategy. Good luck!