Practical Management of Headaches in Patients With Primary and Secondary Brain Tumors.

Abstract

Headaches in patients with brain tumors can be multifaceted and difficult to treat, significantly affecting quality of life. We conducted a narrative synthesis of the literature to discuss the most common causes of and treatments for headache associated with brain tumors. Although increased intracranial pressure due to space-occupying lesions may be the pain driver in some instances, many patients experience secondary headaches that should be treated based on their primary characteristics, such as migraine or tension-like headache. Similarly, the location of tumors can affect pain type, inciting nerve, meningeal, or skull pain, and secondary headaches may also be induced by treatment effects from entities such as posterior reversible encephalopathy syndrome PRES or radiation necrosis. All these headache phenotypes should be treated based on symptoms and pain driver, with a focus on a wholistic approach incorporating both pharmacologic and nonpharmacologic options to improve the quality of life of patients with brain tumors.