This article includes discussion of headache associated with intracranial neoplasms and stroke-like migraine attacks after radiation (SMART) syndrome. The foregoing terms may include synonyms, similar disorders, variations in usage, and abbreviations.
Headaches associated with intracranial neoplasms are common. In this article, the epidemiology, pathogenesis, and clinical presentation of brain tumor-associated headaches are discussed. In addition, uncommon headache syndromes caused by brain tumors, headaches precipitated by the initial treatment of brain tumors, as well as headaches occurring as late complications of brain tumor treatment are described. The approach to new headaches in patients with known malignancies and the treatment of brain tumor headache are briefly discussed.
Historical note and terminology
Headache has been recognized as a common symptom of brain tumors for many years. In the 1940s, a series of classic papers described the clinical characteristics and mechanisms of brain tumor-associated headache (Northfield 1938; Kunkle et al 1942). With improved neuroimaging and the resultant earlier diagnosis, the spectrum of tumor-associated headache has expanded beyond these classical descriptions.
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