Mechanism of Brain Tumor Headache

Abstract

There is an increasing overlap between the primary and secondary headaches and they may actually share a similar biological mechanism. While there can be some criticism that the experimental work with dural and arterial stimulation produced head pain and not actual headache, when considered with the clinical observations about headache type, coupled with improvement after treatment of the primary tumor, we believe that traction on these structures, coupled with increased intracranial pressure, is clearly part of the genesis of brain tumor headache and may also involve peripheral sensitization with neurogenic inflammation as well as a component of central sensitization through trigeminovascular afferents on the meninges and cranial vessels.

Risk factors and analysis of long-term headache in sporadic vestibular schwannoma: a multicenter cross-sectional study

“…29 A number of studies evaluating pain after microsurgery have demonstrated that retrosigmoid craniotomy has a higher early prevalence of headache compared with translabyrinthine and middle fossa resection. 19,28,36,37,45 There are many explanations for this finding. Several studies have demonstrated a reduction in postoperative headache after using cranioplasty, suggesting that adhesions between nuchal muscles and posterior fossa dura may cause pain.…”

“…Although there are currently no studies in the VS literature focusing on longitudinal change in headache symptoms following SRS and conservative observation, surgical series have reported a frequency of baseline headache ranging from 9% to 50% and a prevalence of posttreatment headache ranging from 0% to 75%. 17,24,28,37,38,44,45,47 The low rate of headache seen in some studies is perplexing since, within the general population, the estimated lifetime prevalence of headache is approximately 60%-80%, with roughly 40%-60% of individuals experiencing headaches each year. 42,43 This significant disparity probably stems from heterogeneous study methodology, varying definitions of headache, and differing lengths of follow-up.…”

“…Though there are currently very limited data in the VS literature to validate or discredit this notion, there is convincing evidence within the general neurosurgical literature that intracranial neoplasms contribute to headache, with posterior fossa lesions being more likely than supratentorial tumors to cause head pain. 30,44,45 Mechanisms of headache from intracranial tumors include elevated intracranial pressure from hydrocephalus or venous outflow obstruction, secondary parenchymal or subarachnoid bleed, or traction and compression of pain-sensitive dura mater, meningeal vasculature, or cranial nerves carrying sensory contributions such as the trigeminal, facial, glossopharyngeal, vagus, or upper cervical rootlets. 6,44 Suwanwela and colleagues examined the pattern of headache associated with various intracranial tumors.…”

Editorial: When a Headache Is More Than a Hindrance

“…In this issue, Nelson and Taylor revisit headaches associated with intracranial tumors, a topic that always attracts practitioners' interest . The reasons for this attention are obvious; no practitioner wants to overlook any (potentially) treatable cause of a patient's head pain.…”

An unusual association of headache, epilepsy, and late-onset Kleist’s pseudodepression syndrome in frontal lobe cavernoma of the cerebral left hemisphere

“…In addition, it is estimated symptomatic in 40% of cases. When present, symptoms include headaches, epilepsy due to cerebral hemorrhage and other symptoms depending on the site of the lesion 2–5. Therapeutical options available for patients who have found to have a cavernous malformation are surgery and “stand and wait” approach, depending upon the gravity of each case 6.…”