The headache associated with an intracranial mass is non-specific and often not localizing. It is estimated that almost two thirds of patients with brain tumors complain of headache and that half consider headache to be the primary complaint. The headache of intracranial mass lesion is believed to be due to traction on pain sensitive structures within the cranium including the meninges and dural venous sinuses. The typical headache has a dull, non-throbbing quality, is of moderate intensity, is worsened by physical activity, especially change in posture, and is intermittent. The headache is often associated with nausea and vomiting as is typical migraine headache. Ten percent of adults and two-thirds of children with brain tumors are awaken from sleep by headache. Brain tumor headache may be more prominent upon arising. Supratentorial headaches tend to have some localization to the side of the tumor and posterior fossa tumor headache tends to be bilateral, especially posterior. Any focal finding on neurologic examination or presence of papilledema in a patient with new onset headache requires neuroimaging and follow-up.


 

 

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