Schankin C J, Ferrari U, Reinisch V M, Birnbaum T, Goldbrunner R, Straube A
Neurologische Klinik und Poliklinik, Kilinikum der Universität München, Grosshadern, München, Germany.
Cephalalgia. 2007 Aug;27(8):904-11. doi: 10.1111/j.1468-2982.2007.01368.x. Epub 2007 Jul 17.
Eighty-five brain tumour patients were examined for further characteristics of brain tumour-associated headache. The overall prevalence of headache in this population was 60%, but headache was the sole symptom in only 2%. Pain was generally dull, of moderate intensity, and not specifically localized. Nearly 40% met the criteria of tension-type headache. An alteration of the pain with the occurrence of the tumour was experienced by 82.5%, implying that the pre-existing and the brain tumour headaches were different. The classic characteristics mentioned in the International Classification of Headache Disorders (worsening in the morning or during coughing) were not found; this might be explained by the patients not having elevated intracranial pressure. Univariate analysis revealed that a positive family history of headache and the presence of meningiomas are risk factors for tumour-associated headache, and the use of beta-blockers is prophylactic. Pre-existing headache was the only risk factor according to logistic regression, suggesting that patients with pre-existing (primary) headache have a greater predisposition to develop secondary headache. Dull headache occurs significantly more often in patients with glioblastoma multiforme, and pulsating headache in patients with meningioma. In our study, only infratentorial tumours were associated with headache location, and predominantly with occipital but rarely frontal pain.
对85例脑肿瘤患者进行了脑肿瘤相关性头痛的进一步特征检查。该人群中头痛的总体患病率为60%，但仅2%的患者头痛是唯一症状。疼痛通常为钝痛，强度中等，且无特定定位。近40%的患者符合紧张型头痛的标准。82.5%的患者经历了随着肿瘤发生疼痛的改变，这意味着既往存在的头痛与脑肿瘤性头痛不同。未发现《头痛疾病国际分类》中提到的典型特征（早晨或咳嗽时加重）；这可能是由于患者颅内压未升高。单因素分析显示，头痛家族史阳性和存在脑膜瘤是肿瘤相关性头痛的危险因素，使用β受体阻滞剂具有预防作用。根据逻辑回归分析，既往存在的头痛是唯一的危险因素，这表明既往存在（原发性）头痛的患者更易发生继发性头痛。多形性胶质母细胞瘤患者中钝痛明显更常见，脑膜瘤患者中搏动性头痛更常见。在我们的研究中，仅幕下肿瘤与头痛部位相关，主要为枕部疼痛，但很少为额部疼痛。
