Headache due to brain tumors is often described as which feature?

• A. Worse in the morning, often waking the patient
• B. Worse in the afternoon
• C. Worse with exertion
• D. Absent at night

Answer: (A)

The key idea here is that headaches from a brain tumor often reflect steadily rising intracranial pressure, which tends to be most noticeable after a night of lying flat. When you’re upright, venous drainage and CSF dynamics help keep pressure more stable, but during sleep the brain is recumbent and venous outflow is reduced while the tumor mass and surrounding edema continue to accumulate fluid. This combination can cause ICP to rise by morning, producing headaches that are particularly severe upon waking and may be accompanied by nausea or even brief waking episodes. The pattern is distinct from headaches that worsen later in the day or with exertion, and it explains why the symptom may be absent or less pronounced at night in other scenarios.