| Description |
Up to 75% of patients with intracranial tumors complain of headaches. As a result of modern neuroimaging, however, many tumors are now discovered incidentally, and the percentage of patients with ""silent"" tumors has increased. Forsyth and Posner reported headaches in 48% of their patients with primary or metastatic tumors. The classic brain tumor headache of extreme severity, worse in the morning and associated with nausea and vomiting, was actually quite uncommon. Most patients with brain tumor headaches had symptoms similar to tension-type headache (77%), and another 9% of these patients had symptoms most suggestive of migraine. The typical headache was mild to moderate and bifrontal, but it was worse on the side of the lesion. Unlike tension-type headaches, brain tumor headaches were worse with bending over in about one third of cases, and nausea and vomiting were present in 40%. Suwanwela et al. reported that most brain tumor headaches were nonthrobbing, deep aching, and intermittent. Nocturnal head pain was noted in 71%, early morning headache in 18%, and headache upon arising in 20%. In the majority of children with brain tumor headache, the pain occurs at night, frequently awakening the patient, or in the early morning upon awakening. Sneezing, vomiting, straining at stool, and other similar actions may cause exacerbation of pain, as may changes in position (e.g., bending over, standing up after lying down). Headaches may be paroxysmal, lasting 12 hours. They are often described as ""bursting"" or ""boring,"" and they may be associated with transient focal neurologic symptoms and signs. |
