Preoperative and Postoperative Headache in Patients with Intracranial Tumors

We sought to examine prevalence of headache in patients with histopathologically verified intracranial tumors scheduled for surgery and assess change in headache 1 and 6 months after surgical resection. Possible tumor-related and patient-related predictors for preoperative headache and early postoperative symptom relief were also explored.

The European Organization for Research and Treatment of Cancer has developed a quality-of-life questionnaire (EORTC QLQ-C30) with a brain cancer-specific module, QLQ-BN20, containing 20 questions rating symptoms the past week on an ordinal scale ranging from 1 to 4. Analyses are based on question 4 in this questionnaire.

In this prospective population-based cohort study of 507 patients, we found that headache is a frequent symptom in patients with intracranial neoplasms. 52% reported some degree of preoperative headache, and the prevalence decreased to 43% and 30% 1 and 6 months postoperatively. 19% and 9% reported postoperative worsening or new headache 1 and 6 months after surgery. Younger age, female gender, and occipital tumor location were significant predictors for both preoperative headache and early postoperative relief. In addition, Karnofsky Performance Status <70 was a predictor for headache relief 1 month after surgery. No independent risk factors for worsening or new headache after surgery were identified.

Headache is a common symptom in patients with intracranial tumors, especially in younger and female patients. Many patients experience improvement after surgery, and younger age, female gender, occipital tumor location, and functional dependence were identified as factors associated with early postoperative headache relief.