Headache Centre, Neurological Division, Portogruaro Hospital, Portogruaro, Venice, Italy.
Department of Neurosciences, University of Padua, Italy.
Cephalalgia. 2021 Apr;41(4):431-437. doi: 10.1177/0333102420974351. Epub 2020 Nov 28.
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.
头痛是常与脑肿瘤相关的主要症状之一。继发于颅内肿瘤的头痛已被列入第三版国际头痛疾病分类（ICHD-3）的第 7.4 小节。根据 ICHD-3，如果头痛与肿瘤的发生有密切的时间关系，与肿瘤的恶化平行显著恶化，和/或在成功治疗肿瘤后显著改善，则可归因于脑肿瘤。传统上认为脑肿瘤头痛具有一些特定的临床特征，包括在早晨和/或躺下时加重，valsalva 样动作加重，并伴有恶心和/或呕吐；然而，在现代神经诊断技术出现后进行的研究指出，“典型”脑肿瘤头痛并不常见，特别是在临床出现时。因此，寻找与颅内肿块（所谓的“危险信号”）存在相关的一些特定因素变得至关重要，这些因素可以指导医生做出准确的诊断。
