The headaches of phaeochromocytoma

Of 27 patients with phaeochromocytoma, 20 were subject to headaches as a part of their symptom complex and 7 were not, in spite of the fact that 4 of the latter had experienced other forms of headache at other times. There was no correlation between the proportion of noradrenaline to adrenaline produced by the tumour and the presence or absence of headache or the nature of the headache. Liability to headache appeared to be linked with the rate of change in blood pressure and was not related to absolute values of blood pressure. Two patients experienced a "funny turn" typical of catecholamine release during a spontaneous migraine headache. The migraine headache became pulsatile and severe in one patient but was unaltered in the other. The variable duration and intensity of the headache in different patients can be explained by the pressor and cranial vasoconstrictor effects of the secreted amines which respectively enhance and diminish vascular headache.