Headache or brain tumor?
BY JEANNE MILLSAP Correspondent July 9, 2013 4:26PM
Dr. Markus Chwajol, neurosurgeon at Presence St. Joseph Medical Center’s Neuroscience Institute. | Supplied photo
At A Glance
Symptoms of a meningioma brain tumor include the following:
A headache that worsens over time
A headache that comes with nausea or vomiting
Weakness in an arm or leg
Visual problems, such as double vision, blurriness
Sources: American Brain Tumor Association, www.braintumor.org, and Dr. Markus Chwajol
Updated: August 11, 2013 6:16AM
Many people suffer from the occasional headache. Now and then, like in a scene from an old Woody Allen movie, their thoughts might turn to the possibility of a brain tumor.
The idea borders on hypochondria — the chances of a tumor being the cause of a headache are remote. However, one Plainfield woman recently faced that very diagnosis.
The headaches she had been having about once a month for a dozen or so years were indeed caused by a brain tumor. A very slow-growing one and fortunately a noncancerous tumor, but one that had been growing bigger and bigger over the years, gradually nudging her brain to one side, causing the headaches.
“It was about the size of a lemon or a golf ball,” Anna Pustz said.
Always healthy and active and working as a medical transcriptionist, Pustz said she had thought her chronic headaches were caused by hormones, going along with her cycles. They hit about once a month and lasted for up to three days each time and were always on the left side of her head, just behind her ear.
Then one morning in February, her headache suddenly changed.
“I felt it again behind my ear,” she said, “then it climbed up both sides of my head to my temples and across my eyes. It was more than just a throbbing headache. It was a pinching, throbbing one. It felt like something was about to burst. I grabbed the dresser and the top of my head and shut my eyes tight. ... I thought, ‘Oh, my God, I think I’m going to have an aneurism.’ ”
Alert and coherent, Pustz called 911 and was taken to Presence Saint Joseph Medical Center, where she was scanned and diagnosed with a meningioma — a tumor of the meninges, the thin layers covering the surface of the brain.
“It was scary to realize I had a tumor on my brain,” she said, “but I was kind of relieved when they told me that most meningiomas are benign.”
In fact, according to Dr. Markus Chwajol, neurosurgeon at Presence Saint Joseph Medical Center’s Neuroscience Institute, brain tumors are relatively rare, and the vast majority of meningiomas are benign, or noncancerous.
“We all have experienced headaches,” Chwajol said. “There are 16 different types of headaches, and headaches due to tumors are the least common of those. ... If somebody has headaches, the chances of them being caused by a brain tumor are extremely low.”
Headaches caused by meningioma brain tumors differ from run-of-the-mill headaches, he explained, in that they are most often worse in the morning and can be accompanied by nausea and vomiting. The headache will often feel better after vomiting, Chwajol said. Tumor-induced headaches will not respond as much to pain relievers such as Tylenol, either, he said, and they will return over and over.
They might also cause the person to feel lethargic during the day or notice other neurological symptoms.
“The brain can tolerate some pressure,” Chwajol said, “but there may be certain symptoms depending on where the tumor is located.”
If the tumor is on the left side of the brain, for instance, it might cause speech problems. If on the right, there may be personality changes. A tumor in the back of the brain may cause vision difficulties. The most dangerous, Chwajol said, is when it’s in the skull base, where it can affect vital functions and cause significant damage.
“Anna’s tumor was pressing on her brain,” he said. “It was extremely large.”
Pustz’s meningioma was actually on the front right part of her head, and was pushing the brain and causing pain to be felt on the left side. Four days after Pustz went to the emergency room, Chwajol performed the surgery to remove the tumor. Holes were drilled in her skull, and another type of drill cut through the bone, connecting the holes. The flap of bone and skin was pulled back, and the meninges were cut open.
The tumor could be seen with the naked eye, Chwajol said, and it was removed. A computerized intraoperative guidance system was used to scan the area and help him position his instruments. The surgery went very well, he said, and Pustz was quickly on her way to recovery.
“It was only a couple of days after the surgery when my family took me out to get coffee,” she said. “I just felt like my head was congested, and I had a lot of dizziness for about a week.
“I feel very lucky. I am so incredibly grateful it was not cancerous and that everything turned out fine. They were so good at the Neuroscience Institute. Everyone was.”
Today, five months after her brain surgery, Pustz said she’s enjoying her normal activities. She is making sure she doesn’t overdo things, but she’s back to exercising, running, gardening and even participating in her park district’s boot camp.
Pustz said she knows not every headache is a brain tumor, but she encourages those who have recurring headaches to see their physician, just in case.