Conflict of Interest: None.
Headache Currents—Clinical Review
Mechanism of Brain Tumor Headache
Article first published online: 13 MAR 2014
© 2014 American Headache Society
Headache: The Journal of Head and Face Pain
Volume 54, Issue 4, pages 772–775, April 2014
How to Cite
Taylor, L. P. (2014), Mechanism of Brain Tumor Headache. Headache: The Journal of Head and Face Pain, 54: 772–775. doi: 10.1111/head.12317
- Issue published online: 2 APR 2014
- Article first published online: 13 MAR 2014
- Manuscript Accepted: 7 JAN 2014
- brain tumor;
- dura matter;
Headaches occur commonly in all patients, including those who have brain tumors. Using the search terms “headache and brain tumors,” “intracranial neoplasms and headache,” “facial pain and brain tumors,” “brain neoplasms/pathology,” and “headache/etiology,” we reviewed the literature from the past 78 years on the proposed mechanisms of brain tumor headache, beginning with the work of Penfield.
Most of what we know about the mechanisms of brain tumor associated headache come from neurosurgical observations from intra-operative dural and blood vessel stimulation as well as intra-operative observations and anecdotal information about resolution of headache symptoms with various tumor-directed therapies.
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.