Brain Tumor and Tension Headaches

by Carlo Raj, MD

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    Let’s take a look at brain tumors, part of your chronic headache manifestation. There’s no classic headache syndrome that defines a tumor, or even a mass. So, it’s about suspicion, and that could be a little dangerous because not everyone, not all doctors are going to be as astute as you are. Typically of insidious onset, though could be sudden. Be careful with hemorrhage, right? May be diffuse or localized, but localization does not necessarily imply tumor location. That’s important. May be worse in the morning or waken patient at night due to raised ICP, intracranial pressure. Focal deficit may be present, and obviously, imaging must be done initially. Tension headaches. Most common variety of headache is this. May limit but not prohibit activities. Usually, bilateral, often with occipital, temporal, frontal band. You wear a band around your head if you’re running, exercising. That’s what this particular description is, bandlike predominance. Typically dull and aching, but pressure is not infrequent. Onset is more gradual than with migraine. Remember, migraine, even though it’s a chronic headache, we’re talking about 30 minutes in which all of a sudden, it becomes very, very intolerable. Here, with tension, it’s more gradual. Mild nausea may be present. Associated symptoms are absent or mild. Neurologic exam, actually, unremarkable. And here, it’s important that you pay attention to tenderness in the cervical paraspinal or temporalis muscle, may be seen but is not common nor diagnostic. Just keep that in mind as being, perhaps, a presentation that you’ll be given. Typically respond to your Tylenol, Advil, Aleve. OTC stands for over-the-counter analgesics. Clear? Tension headaches. This is when you start worrying about this patient who becomes addicted to such over-the-counter medication, just because we say over-the-counter, you know that the number one cause of some of these issues...

    About the Lecture

    The lecture Brain Tumor and Tension Headaches by Carlo Raj, MD is from the course Headache. It contains the following chapters:

    • Brain Tumor
    • Tension Headaches

    Included Quiz Questions

    1. Tension headache
    2. Migraine headache
    3. Cluster headache
    4. Subdural headache
    5. Meningitis headahce
    1. Ergotamine
    2. IV ketorolac
    3. Over the counter analgesics
    4. Stress management
    5. Psychotherapy
    1. Migraine headaches present less frequently with a tenderness of cervical paraspinalis muscle in comparison to tension headaches.
    2. Migraine headaches are more gradual in onset in comparison to tension headaches.
    3. Migraine headaches less frequently present with nausea in comparison to tension headaches.
    4. Migraine headaches respond less frequently with Ergotamine in comparison to tension headaches.
    5. Migraine headaches often recur with diurnal variation when not treated for a prolonged period in comparison to tension headaches.

    Author of lecture Brain Tumor and Tension Headaches

     Carlo Raj, MD

    Carlo Raj, MD

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