Preoperative and Postoperative Headache in Patients with Intracranial Tumors

Munkvold, Bodil Karoline Ravn; Sagberg, Lisa Millgård; Jakola, Asgeir Store; Solheim, Ole

doi:10.1016/j.wneu.2018.04.044

Cited by 10 publications

(11 citation statements)

References 32 publications

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“…Remission of brain tumour-related headache occurs in most patients who undergo surgery, but it is not the rule. In a recent study on preoperative and postoperative headaches in patients affected by intracranial tumours (18), the prevalence of headache decreased from 52% at baseline to 43% and 30% at 1 and 6 months postoperatively, while worsening of the previous headache was observed in 19% and 9% at the 1 and 6-month follow up. No independent risk factor for worsening or new headache after surgery could be identified.…”

Section: Clinical Characteristics Of Headache Associated With Brain Tmentioning

confidence: 97%

“…No independent risk factor for worsening or new headache after surgery could be identified. On the contrary, younger age, female gender, low Karnofsky Performance Status (KPS), and tumor location in the occipital lobe were significant positive predictors for experiencing early postoperative relief (18).…”

Section: Clinical Characteristics Of Headache Associated With Brain Tmentioning

confidence: 99%

“…Tumours that typically provoke headaches include intraventricular, midline, and posterior fossa lesions. They can all produce an obstruction of cerebrospinal fluid drainage causing hydrocephalus and dislocation of the periventricular nociceptive structures (18,24); however, many pathophysiological aspects remain unclear. Even in tumours of apparently the same size, location, and histological type, the accompanying headache may be very different and sometimes may not be present at all (6).…”

Section: Pathophysiologymentioning

confidence: 99%

“…Since brain tumour headache usually disappears or improves after surgery (5,6), although in a minority of patients it may persist or even get worse (18), its therapy is mainly based on treatment of the underlying tumour, unless contraindicated for a presumed high risk of morbidity and mortality, particularly in the case of benign tumours. In cases of patients who are medically unfit for surgery or in whom the risks of surgery outweigh the benefits, a conservative approach should include prevention and management of medication overuse.…”

Section: Treatment Of Headache Associated To Brain Tumoursmentioning

confidence: 99%

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Update on headache and brain tumors

2020

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Headache is one of the leading symptoms often associated with brain tumours. Secondary headaches attributed to intracranial neoplasias have been included in subchapter 7.4 of the third edition of the International Classification of Headache Disorders (ICHD-3). According to ICHD-3, the headache may be attributed to a brain tumour if it has developed in close temporal relation with the development of the neoplasia, has significantly worsened in parallel with the worsening of the tumour, and/or has significantly improved following the successful treatment of the neoplasia. Brain tumour headache was traditionally thought to display some specific clinical characteristics, including worsening in the morning and/or when lying down, being aggravated by Valsalva-like manoeuvres and accompanied by nausea and/or vomiting; however, the studies performed after the advent of modern neurodiagnostic techniques have pointed out that the “classic” brain tumour headache is uncommon, particularly at the time of clinical presentation. Therefore, it becomes critical to seek some specific factors associated with the presence of an intracranial mass (the so-called “red flags”) that can guide the physician to establish an accurate diagnosis.

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Section: Clinical Characteristics Of Headache Associated With Brain Tmentioning

confidence: 97%

Section: Clinical Characteristics Of Headache Associated With Brain Tmentioning

confidence: 99%

Section: Pathophysiologymentioning

confidence: 99%

Section: Treatment Of Headache Associated To Brain Tumoursmentioning

confidence: 99%

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Update on headache and brain tumors

2020

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“…Cases studies have proposed that general anesthesia and opioids may be related to the development of postoperative migraine headaches [ 14 , 15 , 16 , 17 , 18 ]. Although several risk factors were reported for postoperative headache, it remains unclear whether general anesthesia increases the risk of postoperative migraine compared with other forms of anesthesia [ 3 , 19 , 20 , 21 ]. In addition, risk factors for postoperative migraine episodes are also largely unknown in current literature.…”

Section: Introductionmentioning

confidence: 99%

Migraine Headaches after Major Surgery with General or Neuraxial Anesthesia: A Nationwide Propensity-Score Matched Study

Liao

Liu

et al. 2021

IJERPH

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Migraine headaches can be provoked by surgical stress and vasoactive effects of anesthetics of general anesthesia in the perioperative period. However, it is unclear whether general anesthesia increases the migraine risk after major surgery. Incidence and risk factors of postoperative migraine are also largely unknown. We utilized reimbursement claims data of Taiwan’s National Health Insurance and performed propensity score matching analyses to compare the risk of postoperative migraine in patients without migraine initially who underwent general or neuraxial anesthesia. Multivariable logistic regressions were applied to calculate the adjusted odds ratio (aOR) and 95% confidence interval (CI) for migraine risk. A total of 68,131 matched pairs were analyzed. The overall incidence of migraine was 9.82 per 1000 person-years. General anesthesia was not associated with a greater risk of migraine compared with neuraxial anesthesia (aORs: 0.93, 95% CI: 0.80–1.09). This finding was consistent across subgroups of different migraine subtypes, uses of migraine medications, and varying postoperative periods. Influential factors for postoperative migraine were age (aOR: 0.99), sex (male vs. female, aOR: 0.50), pre-existing anxiety disorder (aOR: 2.43) or depressive disorder (aOR: 2.29), concurrent uses of systemic corticosteroids (aOR: 1.45), ephedrine (aOR: 1.45), and theophylline (aOR: 1.40), and number of emergency room visits before surgery. There was no difference in the risk of postoperative migraine between surgical patients undergoing general and neuraxial anesthesia. This study identified the risk factors for postoperative migraine headaches, which may provide an implication in facilitating early diagnoses and treatment.

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