Headaches in Patients with Brain Tumors

Although most people who suffer from headache do not present with an underlying mass lesion, a large number of patients with brain tumors do complain of headache (as many as 60% in our institution). The problem for clinicians is that the tumor-headache association is not universal, as evidenced by anecdotal reports of patients with large tumors, elevated intracranial pressure but a complete absence of headache. In this chapter, we examine over 80 years of research on brain tumor headaches, delineating the link between tumor location, laterality, growth-rate, and pain. Most importantly, we position our review within the context of current aetiological theories and propose new models involving the peripheral and central sensitization of nociresponsive neurons. A brief examination of headaches as a result of surgery and adjuvant chemo-radiation therapy is also provided.