Can waking nearly every night with left or right temple pain mean an aneurysm or a brain tumor?

“Such localized repetitive headaches are quite unusual and suggest the possibility of a serious underlying disorder such as a tumor or vascular problem,” says Morton Tavel, MD, Clinical Professor Emeritus of Medicine, Indiana University School of Medicine, and author of “Health Tips, Myths, and Tricks: A PHYSICIAN’S ADVICE.”

Dr. Tavel explains, “Less commonly, a variant of migraine headaches could manifest in this way, but having such a problem should trigger a visit to a physician for more intensive evaluation and testing.”

A benign cause could be a pinched nerve in the neck. When a nerve is compressed in the neck area and causes pain elsewhere, this is called cervical radiculopathy.

It can, indeed, radiate pain into the head, including behind the eye and at the temple. And it can be sudden and sharp, enough to pull you out of sleep.

In addition, irritation to the muscles in the neck and shoulder from exercise can cause a radiating of pain into the temple.

But the kink in this chain is when the temple pain occurs almost every night. A muscle problem will calm down.

Even a cervical pinched nerve shouldn’t be causing head pain to wake someone on a regular basis.

Brain Tumor and Temple Pain

When a brain tumor causes a sudden pain in the head, there is nothing about this disease that would confine the symptom to only during sleep.

Morning headaches that keep happening and that take several hours to subside once out of bed are suspicious for a brain tumor, since the cancer overnight causes fluid buildup in the brain.

A brain tumor can cause headaches at any time, however. That the pain occurs in the temple as opposed to the top, side or back of the head is not indicative of the cause as far as brain tumor vs. vascular problem vs. migraine.

What’s more concerning is that it keeps waking you from sleep and especially if it’s of a severe nature.

Brain tumor

Middle of the night awakenings from any kind of head pain are just plain scary, especially if it’s sharp or stabbing.

If you’re been having additional symptoms such as changes in vision, balance problems, memory issues, unexplained weakness or weight loss, nausea, vomiting or new-onset daytime headaches that don’t respond well to painkillers – do not waste another moment making an appointment with your doctor.

Your doctor will likely order an MRI of your head and/or refer you to a specialist who will order the MRI.

Vascular Problem and Temple Pain

A cerebral aneurysm is a bulging blood vessel in the brain. Its walls are weak, and the pressure of blood coursing through them can threaten to tear the vessel, causing life-threatening hemorrhaging.

Aneurysm. A rupture is a hemorrhagic stroke.

“Aneurysm rupture headaches are almost always sudden, bad and do not improve with any routine measures such as rest or pain medications,” says Farhan Siddiq, MD, a neurosurgeon with University of Missouri Health Care.

An aneurysm may also not burst right away, but slowly leak blood, causing ongoing headaches.

Dr. Siddiq explains, “It’s very unusual for an aneurysm to be ‘slowly leaking.’ Sentinel [early warning] bleeding can occur from an aneurysm.

“This is considered an early warning sign of catastrophic aneurysm bleeding likely to occur in the near future.

“Therefore, emergent medical help should be acquired at the closest comprehensive stroke center.

“As a requirement, all comprehensive stroke centers should have 24/7 capability of evaluating and treating aneurysms on a daily basis.

“A common description of a sentinel bleed or full rupture of an aneurysm is the ‘worst headache of my life,’ and is also described as a thunderclap headache.

“There may be associated syncope [faint feeling] or nausea, vomiting or a seizure.

“The head component may be sometimes difficult to assess, for the patient as well as the treating physician, particularly in patients who have a history of chronic, daily headaches.”

Morning Headache: Other Cause

A morning headache can be bad enough to wake you up before your alarm is set to go off.

Another cause is untreated sleep apnea. However, these particular headaches are gone within 30 minutes of getting out of bed.

Other Causes of Temple Pain
Bad Enough to Wake You Up

The less often this occurs, the more likely it has benign origins such as TMJ disorder, a spontaneous muscle spasm, an irritated nerve and idiopathic (no known cause).

It’s reassuring when, if this has been going on for a while, you still don’t have other worrisome symptoms such as a new lump at the temple or dizziness.

But don’t wait for time passage to reassure you. See your doctor.

Dr. Siddiq is fellowship-trained in endovascular surgical neuroradiology and vascular neurology from the University of Minnesota Medical Center. His areas of special focus also include brain aneurysms and carotid disease.

Dr. Tavel’s medical research includes over 125 publications, editorials and book reviews in peer-reviewed national medical journals. He was formerly director of the cardiac rehabilitation program at St. Vincent Hospital in Indiana. mortontavel.com
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.