Head Pain from Cancer
Primary Neoplasm
This involves primary brain tumors i.e. tumors that have not metastasized from other areas of the body. 2-3 cases per 100,000 are reported in Europe and North America, with Glioblastoma the most common form. More common in men, primary neoplasms of the head have a peak incidence in patients between 45-70 years old. In children, the average time from symptom onset to diagnosis is 75 days. Due to the fact that the mechanism of headache associated with cancer may be the same as with primary headaches, it is important to monitor in our patients.
Presentation
In Children, headaches occur with:
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Risk Factors
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Diagnosis
A diagnosis can be made through an MRI with and without contrast Recommendation
Refer to the patient's primary care physician if you suspect a primary neoplasm involvement |
Effects of Chemotherapy and Radiation Treatments
Radiation treatment may cause edema in the brain causing a headache that is responsive to corticosteroids. The chemotherapeutic agents involve in therapy may cause oxidative stress resulting in head pain.
Risk Factors
Prior history or family history of migraine headaches Use of certain chemotherapeutic agents, especially Temozolomide. |
Presentation
Typically occurs within two weeks of treatment. They may develop into chronic headaches The head may occurs concurrently with chemotherapy or radiation therapy Migraine type is the most common |
SMART Syndrome
Stroke-like migraine attacks after radiation therapy that typically occurs in patients who previously had cranial neoplasm with radiation therapy. SMART Syndrome is considered a consequence of therapy which is more common in men. Research has suggested there is a genetic disposition for developing the SMART Syndrome.
Stroke-like migraine attacks after radiation therapy that typically occurs in patients who previously had cranial neoplasm with radiation therapy. SMART Syndrome is considered a consequence of therapy which is more common in men. Research has suggested there is a genetic disposition for developing the SMART Syndrome.
Headaches may occur with neurological deficits:
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Diagnosis
Past medical history and current medication use consistent with radiation chemotherapeutic agents |
Recommendation
Call or refer to the patient's primary care physician if you suspect chemotherapy involvement rather than musculoskeletal |