THE CLINICAL CHARACTERISTICS OF SECONDARY HEADACHE

BACKGROUND Given the range of disorders that are implicated in manifesting as headache, a detailed analysis and interpretation of the pattern of headache would be of immense help in distinguishing the rarer life-threatening causes of secondary headaches from the more common primary headaches. MATERIALS AND METHODS This is an observational study to analyse the headache pattern, secondary headache in patients having diagnosed to have brain tumour with the details of neoplasm by imaging and biopsy. RESULTS 208 patients with brain neoplasm either primary or secondary were analysed. 11.5% did not have headache. During onset, supratentorial tumours had ipsilateral frontoparietal localisation, pituitary tumours and tumours causing raised intracranial pressure had bilateral and infratentorial tumours without raised ICP to occipital localisation. All these later had become generalised. More greater intensity headaches were seen with gliomas, meningioma, and tumours that have caused raised intracranial pressure. Intracranial pressure is more commonly seen with gliomas, ventricular tumours like ependymoma, colloid cyst of ventricles. CONCLUSION The features suggesting probable secondary cause are unilaterality, dull ache, recent onset or change in pattern with pre-existing headache, progressive in nature and in association with seizures or neurological deficits. The extent of tumour-associated oedema, and raised intracranial pressure are significantly important factors in tumour-associated headache.