When a headache really is a brain tumor

• It's become a classic scenario: You have a headache and after Googling it, you find out a headache can be a sign of a brain tumor.
• If you rush to the emergency room suspicious that you have a tumor or something else deadly serious, chances are you're being paranoid. But sometimes you're not being paranoid -- you're being right.
• That's what happened to Debbie Tonich when her son John's headache, diagnosed initially as dehydration or a flu bug, turned out to be a cancerous tumor. In this case, paranoia -- or some would call it mother's intuition -- paid off.
• "I think I saved his life," Debbie says.
• John's story
• One Sunday in February, shortly after a wrestling match, 16-year-old John Tonich, a high school sophomore, started having short, sharp headaches.
• "They lasted 10 seconds, and I'd have to take a second and sit down or go stand off to the side," John remembers. "I had three or four of them a day."
• At first his parents thought it was a concussion, since John had been thrown to the mat during his match. Two days later, when the headaches didn't go away, they took John to their family doctor in Parma Heights, Ohio. She diagnosed dehydration, which made sense to the family since John had been drinking less to fit into a lower weight class for wrestling. She drew some blood from John and told him to drink Gatorade.
• Two days later, on Thursday morning, the headaches disappeared, but John was feeling nauseated. Debbie took him back to the doctor and asked if it could be a concussion, and John wondered out loud if it could be an aneurysm. They say their family doctor told them it was probably the stomach bug that was going around.
• "As we were walking out the door, she handed us a prescription for a CT scan, and said, 'Just in case,'" Debbie remembers.
• "The worst possible tumor in the worst possible place"
• The Toniches never used that prescription.
• The day after that second visit to the doctor, John texted Debbie from school that he felt dizzy. She picked him up and went right to the emergency room.
• "I didn't use the prescription, because then I'd have to wait for an appointment, and I knew that could be a while, and then I'd have to wait again for the results," she says.
• At the emergency room, John had a CT scan and then an MRI.
• "The doctor came in and told John he had the worst possible cancer in the worst possible place and would have a year to live, or two at the most," his father, Joe, remembers. "We came in thinking he had a slight concussion and left with a death sentence."
• John immediately went by ambulance to the Cleveland Clinic, where it turned out the situation wasn't nearly as dire as the ER physician had made it sound. It turned out he had a medulloblastoma, a tumor diagnosed in about 1,000 people every year, according to the American Brain Tumor Association.
• Dr. Tanya Tekautz, John's doctor and co-director of the Pediatric Brain Tumor Program at the Cleveland Clinic, says 50 to 60 percent of children with the same type of medulloblastoma John has are still alive five years after their diagnosis.
• John's family says the surgeon managed to remove the entire tumor, and he's now in a clinical trial receiving both radiation and chemotherapy.
• The Toniches don't blame the family doctor for not figuring out John had a brain tumor, since headaches can mean so many different things.
• "She went with what was logical," Joe says.
• They're certainly glad, though, that they took matters into their own hands and went to the emergency room. Debbie says her son's illness just didn't seem like a flu, when someone usually suffers many symptoms all at once.
• "Everything that went wrong was single things -- first the headaches came and went, then the nausea, then the dizziness. It just didn't make sense," she says. "If something doesn't feel right, keep pressing. Don't stop."
• Headaches usually aren't brain tumors
• Of course, John's story is highly unusual; the vast majority of people who have headaches don't have brain tumors.
• "Ninety-nine percent of the time, a headache isn't cancer," says Dr. Gene Barnett, director of the Brain Tumor and Neuro-Oncology Center, who treats adults at the Cleveland Clinic. "It's a stress headache or a migraine or sinusitis or something else benign."
• For every 4,000 children who have headaches, one will have a brain tumor, according to Dr. Santiago Medina, co-director of the Department of Radiology's Division of Neuroradiology at Miami Children's Hospital.
• Of course, there's no simple way to tell whether your headache is a brain tumor, but doctors do have some red flags. Before reading them, there are some important points to remember. First, 50%-60% of all people with brain tumors don't have headaches at all, Barnett says. Second, your headaches could fall into all these red flag categories and you could not have cancer. Third, your headaches could fall into none of these categories and you could still have a brain tumor.
• Red flag No. 1: These headaches are new for you
• If you don't usually have headaches, or if this is a different type of headache from the ones you usually have, that could be a warning sign, Medina says.
• Red flag No. 2: Your headaches are accompanied by other symptoms
• Barnett says he rarely sees a brain tumor patient whose only symptom was a headache. Most of the time, the person also has something else, such as nausea, dizziness, or vomiting. Sometimes the signs are even more obvious, such as seizures, difficulty speaking, weakness in the limbs, or problems with peripheral vision.
• Red flag No. 3: Your headaches start when you wake up in the morning
• Typically, when someone has a brain tumor, the headaches start in the morning often accompanied by nausea and vomiting and get better as the day goes on, Barnett says.
• "Headaches that come on as the day wears on and get worse into the evening are typically not associated with brain tumors," he adds. "They're more associated with the stress of daily life."
• Red flag No. 4: Your headaches get worse over time
• If your headaches get worse over a period of days, weeks, or months, that could be a warning sign, Barnett says.
• Red flag No. 5: Something just doesn't seem right
• You can have none of these red flags and still have a brain tumor. If your inner voice, or your doctor's inner voice, says something is seriously wrong, listen to it.
• "Guidelines are just guidelines," Medina says. "There are cases where the mother says my child doesn't look right, or where the pediatrician says the child doesn't look right, even though I can't put my finger on it, and we do imaging on those kids."
• The American Brain Tumor Association and the National Brain Tumor Society have more information on symptoms of a brain tumor.
• Cleveland Clinic has specific information about pediatric brain tumors.

Syrian warplanes pound targets near Turkey

• As Syrian government warplanes operated uncomfortably close to Turkey's border again Wednesday, U.S. Secretary of State Hillary Clinton backed up American support for the opposition by adding to Washington's humanitarian aid.
• Government jets pounded Ras al-Ain, a town near Turkey's border, for yet another day, shaking residents on the other side and triggering demands from Ankara that the Syrian military "stop this as soon as possible."
• Read more: France, U.S. stand behind new opposition alliance
• Turkish Defense Minister Ismet Yilmaz told journalists Wednesday that the country would "respond to Syrian planes or helicopters that violate our borders."
• "Our citizens, especially the residents of the (border]) regions, should stay calm. Our armed forces are on duty full time and the troops on the ground have been authorized to intervene immediately when necessary," the minister said.
• Attacks on Ras al-Ain earlier in the week sent Syrians fleeing for the border. A total of 5,000 crossed into Turkey Monday and Tuesday, according to a Turkish government official, who declined to be named because he is not authorized to speak with the media.
•  Nic Robertson: Syria's Frontline Town Syrian opposition forms new coalition
• Government warplanes also bombarded Damascus and flashpoints in the country's north, according to the opposition Local Coordination Committees.
• So far Wednesday, fighting has claimed the lives of 62 people, the LCC said.
• Clinton, speaking Wednesday from Perth, Australia, announced a $30 million injection of new food assistance for people inside Syria and refugees in neighboring countries, raising the total U.S. aid to $200 million.
• France and the United States backed a new coalition of Syrian dissidents Tuesday, but Damascus slammed the group, saying any effort to topple President Bashar al-Assad will be futile.
• After 20 months of relentless turmoil, rebel forces had not had a unified vision for the country or a military plan to oust al-Assad, whose family has ruled Syria for more than four decades. The United States and Arab nations pressured the groups to get on the same page.
• The new coalition agreed that it wants al-Assad gone and that no one would talk with his government. Spokesman Mohammed Dugham said the only option now is a totally new government.
• A total of 107,769 Syrian refugees have arrived in Turkey as of October 30, Turkey's state news agency Anadolu reported, citing Turkish Foreign Minister Ahmet Davutoglu.
• The U.N. refugee agency says more than 408,000 Syrians have fled their country, and the number is rising.

Clashes as austerity anger drives Europe strikes

• A wave of anger over austerity is sweeping across Europe as workers fed up with government spending cuts and tax rises take to the streets in a coordinated day of action.
• Some of the largest, and most violent, protests are taking place in Spain, where a general strike is under way. Public transport has been shut down, or disrupted, while many schools, shops, factories and airports are closed.
• There were also significant walkouts -- and outbreaks of violence -- in Portugal, Greece and Italy. Limited protests are taking place in other countries, including France and Belgium -- and even in Germany where the traditionally strong economy has taken a hit.
• Transport across the continent is being disrupted by the strikes. Hundreds of flights have been grounded, and there are severe reductions in intercity rail services and local transit systems.
• Protesters say the cuts will compromise livelihoods and increase unemployment. Clashes are reported to taken place between police and activists in various cities.The strikes have been called by the European Trade Union Confederation, which represents 85 separate organizations across the continent. "Austerity is a total dead end, and must be abandoned. Social protection and wages can no longer be sacrificed," it said on its website.
• "This is a social emergency, and it is time to listen to what the citizens and workers have to say, and to change course."
• In Spain, this is the second general strike in a year. The country's two largest unions have plenty to protest about with unemployment standing at more than 25% and cuts from health to education.
• Nuria Manzano, from the UGT union explained why it was important for workers to support the action. "The cuts aren't limited to Spain. They are happening in the whole European Union.
• "That's why it is important that all Europe protest against these cuts and against this way to do politics."
• But despite the recent violent social unrest and the rise of suicides blamed on increasing financial hardship the government is sticking to its fiscal plan. Spanish PM Mariano Rajoy said: "I said I would lower taxes, but I am raising them, I haven't changed my criteria nor will I decline to put them down when possible, but circumstances have changed and I must adapt to them."
• It's a similar picture in neighboring Portugal where protesters are taking part in what they're calling a "coordinated day of action."
• Portugal's main trade unions say the protests are meant to show mass discontent and send European leaders a warning.
• Months of quiet resignation in the country have turned to anger and discontent. A combination of severe tax increases -- and rising unemployment -- have made social unrest the norm.
• Unemployed Pedro Barroso explained the reason for the unrest. "You see people participating in demonstrations more and more. The social awareness is noticeable. This year we had more demonstrations than in the last 20 years!"
• On Monday several hundred people took to the streets as German Chancellor Angela Merkel visited the Portuguese capital to rally morale. Many held banners saying: "Merkel, you're not welcome."
• In Italy, clashes broke out in Rome, Milan and Turin with several police officers reported injured. The unions say the strike is designed not to damage the economy, but to show the scale of the opposition to austerity cuts. "This is a government that is destroying all the rights to social services with the excuse of the European Union," said one demonstrator, Felice Nardi.
• "We believe that the voice of the workers should finally be heard because they are the ones suffering. There have been a series of measures that are really bringing the people to ruin."
• On Monday, with youth unemployment approaching 35%, 3,000 students vented their anger. "We are students and our future is at stake and we need to do something," said one student called Chiara. "If we don't do something, who will?"
• CNN's Ben Wedeman said the government must strike a fine balance between sometime violent domestic oppostion and its international debt obligations. "In elections next year we'll see how successful the government was in achieving this balance."
• In Greece, police said 5,000 people took to the streets to protest peacefully over the economic pain they are suffering. In the last two years alone public sector workers have seen their wages shrink by up to 40%.
• One unemployed civil servant Evangelia Katsaropoulou explained why she planned to join the protests. "I have two children, they're twins, and the situation is tragic," she told CNN.
• "What I want to say to everyone is that they have to come onto the streets and shout so that these measures do not take place."
• The International Monetary Fund and the European Union are debating whether and when Greece can receive its next bailout payment.
• Protesters, such as pensioner Thimios Marvitsas, hope to remind them that they are the ones bearing the burden of austerity. "All these measures they are pushing us back 50, 60 years," he said.
• "They are cutting our pensions in half, there is a million unemployed, more taxes. In other words our lives are just getting worse and worse."
• Even in Germany there were expected to be protests later in the day, albeit limited in their scale. CNN's Fred Pleitgen said they were called by unions more in solidarity than in real anger. However he added that the economy was slowing down and the eurozone crisis was taking its toll on the labor market. Unemployment is lower than in other countries but trades unions warn that austerity measures could damage the economy.
• "Angela Merkel has become a lightning rod for protesters across Europe due to anger over her insistence that debt-ridden countries adopt austerity," he said. "Now the same is happening in Germany itself."

Rockets, airstrikes reignite Mideast conflict

• Israel launched a series of blistering air strikes Wednesday on what it says are terrorist targets in Gaza, killing the chief of Hamas' military wing and at least eight others, Israeli and Palestinian officials said.
• Palestinian leaders immediately condemned the attacks as an escalation, with President Mahmoud Abbas calling for an emergency session of the Council of the League of Arab States to discuss what he called Israeli "aggression," the Egyptian state news agency MENA reported.
• Hamas' military wing warned that Israelis had opened "the gates of hell on themselves" with the move.
• A report on the Israel Defense Forces (IDF) website said Brig. Gen. Yoav Moredechai would not rule out a ground attack.
• "Infantry brigades have been shifted in preparation for the operation," he said, according to the website.
• Israeli military spokeswoman Lt. Colonel Avital Leibovich said: "There are some reserve units that are preparing but nothing more than that at this point."
• There were at least 35 airstrikes in an eight-hour span, Hamas security sources said. As night fell, more air strikes could be heard, and Hamas security officials said four more attacks hit empty swaths of farmland in Gaza late Tuesday.
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• Map: Israel
• Israel's Iron Dome air defense system intercepted 17 rockets launched at Israel in the span of a few hours, the IDF said, and a rocket struck a shopping center in a major city in southern Israel. The IDF said at least 130 rockets had been fired from Gaza since Saturday.
• Palestinian medical sources said nine people died in the Israeli air strikes, including a young girl, and 35 others were wounded, with 10 in serious condition. However, the health minister in Gaza, Mufid al-Mukhalalati, put the death toll at seven, including two young girls.
• The dead included Ahmed al-Ja'abari, the popular and influential head of the Hamas military wing, and his son, the group said on its website.
• The Israeli operation -- which the military calls "Operation Pillar of Defense" -- came after Prime Minister Benjamin Netanyahu warned this week of pending retaliation by Israel for increased rocket attacks from Gaza.
• "I would ask you, I'd ask any person around the planet: What would you do if your population was targeted day after day?" Israeli government spokesman Mark Regev told CNN, later adding that "you have to see our operation as fundamentally defensive."
• Egypt recalled its ambassador to Israel on Tuesday, the Israeli Foreign Ministry said.
• The United States said Israel has the right to defend itself, according to a statement from the State Department.
• "We strongly condemn the barrage of rocket fire from Gaza into southern Israel, and we regret the death and injury of innocent Israeli and Palestinian civilians caused by the ensuing violence," the statement said. "There is no justification for the violence that Hamas and other terrorist organizations are employing against the people of Israel. We call on those responsible to stop these cowardly acts immediately."
• A spokesman for Hamas, Osama Hamdan, claimed that Hamas has been defending itself from Israeli attacks.
• "I think the ones who declared war was Israel, and I think the Palestinians are in the position of defending themselves and nothing more than this," he said. Hamas will resist as long as the Israeli offensive lasts, Hamdan said.
• Israeli navy ships could be seen firing into Gaza from the Mediterranean. The navy struck "terror sites" there, the IDF said via Twitter.
• The Israeli military said in a statement Wednesday it targeted "a significant number of long-range rockets sites" to deliver "a significant blow" to Hamas' underground rocket-launching capabilities and munitions warehouses.
• Some of the munitions warehouses were in civilian residential buildings, which showed that Hamas uses a strategy of human shields, Israeli military sources said.
• "The aim of targeting these sites is to hamper their rocket-launching weapons build up capabilities," the IDF statement said, adding that the Gaza strip had become "a frontal base for Iran firing rockets and carrying out terrorist attacks against Israeli citizens."
• Angry crowds gathered at the heavily damaged vehicle that contained the bodies of al-Ja'abari and his bodyguard.
• Saeb Erakat, the chief Palestinian negotiator, condemned "in the strongest possible terms" what he called the Israeli assassination of al-Ja'abari.
• In an interview with CNN, Erakat labeled the attack the beginning of a "major, major Israeli escalation," and he called on the international community to pressure Israel to halt its operation.
• Al-Mukhalalati, the Gaza health minister, also called on "the free world to stop this massacre committed by Israel."
• Asked about assassinating al-Ja'abari, Regev told CNN that the Hamas military leader headed a "terror military machine."
• "This is the man with blood on his hands. This man is a known and wanted terrorist," he said. "In taking him out, Israel was acting legitimately."
• The latest escalation in violence is part of a cycle of attacks between periods of relative stability between Israel and the Palestinians.
• "This was both inevitable and predictable," said Aaron David Miller, a Middle East expert and vice president at the Woodrow Wilson Center.
• There is no long-term basis for both sides to find a lasting peace, he said.
• Israel and the Palestinians have "completely different political and strategic goals," Miller explained. The focus should be on how to bring security until a basis for long-term stability arises, he added.

After months of mystery, China set to unveil new top leaders

• Beijing (CNN) -- The small group of people who will set the agenda for China for the next decade is expected to be unveiled to the world on Thursday after months of secretive bargaining and abundant speculation.
• A far cry from the relentless media campaigns and frequent public appearances of U.S. presidential candidates, the efforts to determine who ends up on the elite panel that sits atop the Chinese political system have taken place behind closed doors.
• They are part of a once-in-a-decade leadership transition taking place in the Chinese Communist Party, which has ruled the world's most populous nation for the past six decades.