J Neurooncol. 1991 Feb;10(1):31-46. doi: 10.1007/BF00151245.
In this report we present aspects of the epidemiology of headache (i.e., pain in the head, face, ear, or neck) among children with brain tumors. The data are derived from the 3,291 subjects in the Childhood Brain Tumor Consortium databank. Overall, 62% of the children with brain tumors experienced chronic or frequent headaches prior to their first hospitalization: 58% of children with supratentorial tumors and 70% of children with infratentorial tumors. The relative frequency of headache increased through age 7 and then leveled off regardless of tumor location. For children under age 5, headache rarely had a duration of more than 1 year prior to hospitalization. Among children over age 4, headache duration of at least one year was significantly greater for supratentorial than for infratentorial tumors. Children with a brain tumor and headache had a different distribution of symptoms and neurologic signs than those without headache. Tumor location and headache status were interactively associated with the presence of other symptoms and neurologic signs. Children with headache had a greater number of other symptoms and neurologic signs. Regardless of tumor location among children with headache, nausea or vomiting, papilledema, and hypoactive tendon reflexes were more frequent, while upper extremity weakness, optic atrophy, and irritability were less frequent. Diplopia, coma, stiff neck, anesthesia or hypesthesia, pupillary abnormalities, and abnormalities of personality, academic performance, or speech were associated with headache in children with supratentorial tumors. No specific symptoms or neurologic signs were associated with headache in children with infratentorial tumors. Supratentorial craniopharyngioma, ependymoma, and protoplasmic astrocytoma were associated with significantly high rates of headache as was infratentorial pilocytic astrocytoma.
在本报告中，我们阐述了脑肿瘤患儿头痛（即头部、面部、耳部或颈部疼痛）的流行病学特征。数据来源于儿童脑肿瘤联盟数据库中的3291名受试者。总体而言，62%的脑肿瘤患儿在首次住院前经历过慢性或频繁头痛：幕上肿瘤患儿中58%，幕下肿瘤患儿中70%。头痛的相对发生率在7岁前上升，之后无论肿瘤位置如何均趋于平稳。对于5岁以下儿童，住院前头痛很少持续超过1年。在4岁以上儿童中，幕上肿瘤引起的头痛持续至少1年的情况明显多于幕下肿瘤。患有脑肿瘤且头痛的儿童与无头痛的儿童在症状和神经体征分布上有所不同。肿瘤位置和头痛状态与其他症状和神经体征的存在存在交互关联。有头痛的儿童有更多其他症状和神经体征。在有头痛的儿童中，无论肿瘤位置如何，恶心或呕吐、视乳头水肿和腱反射减弱更为常见，而上肢无力、视神经萎缩和易怒则较少见。复视、昏迷、颈部僵硬、感觉减退或感觉缺失、瞳孔异常以及人格、学业成绩或言语异常与幕上肿瘤患儿的头痛有关。幕下肿瘤患儿的头痛未发现与特定症状或神经体征相关。幕上颅咽管瘤、室管膜瘤和原浆性星形细胞瘤以及幕下毛细胞型星形细胞瘤与头痛的发生率显著升高有关。
