Headaches are uncommon as the initial symptom of an acoustic neuroma. Before treatment, many people with an acoustic neuroma may feel a sensation of fullness in their head and in the back of the ear, near the site of the tumour. This feeling is caused by the presence of the tumour inside the skull. The expanding tumour stretches the membranes outside the brain, causing discomfort. Even large tumours may not cause severe headaches.

After surgical removal of an acoustic neuroma, headache may be a problem. The most common cause of post-operative headache results from the incision through muscles at the time of surgery. The brain itself does not feel pain, but the lining inside the skull and the tissue around the site of the operation are both sensitive to pain.

Another cause of post-operative headache is sensitivity of the bony margins in the area of the operation. The edge of the bone is very sensitive, and the tissue that goes over the bone, covering the surgeon’s ‘window’ used for removal of the tumour, is super-sensitive and painful to the touch. It may take several months or even longer before the sensitivity resolves itself. Rarely is headache after tumour surgery a symptom of a recurrence of the tumour.

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