[Headache of unknown origin: brain tumor? Indications for computer tomography]

Area of Science:

• Neurology
• Neurosurgery
• Oncology

Background:

• Headache is the most common presenting symptom of brain tumors.
• Brain tumors can present solely with headache for extended periods, delaying diagnosis.

Purpose of the Study:

• To analyze the characteristics of headaches associated with brain tumors.
• To evaluate the diagnostic efficacy of computerised tomography (CT) for brain tumors presenting with headache.

Main Methods:

• Retrospective analysis of 25 brain tumor patients presenting with headache.
• Comparison of diagnostic methods including electroencephalography, skull X-ray, scintigraphy, sonography, and CT.

Main Results:

• A significant delay (average 40 months) between initial headache and other neurological symptoms was observed.
• Slow-growing, operable tumors were more common in patients with long-standing headaches.
• Tumors occurred in silent brain regions (subdominant hemisphere, frontal lobes, sella area).
• Computerised tomography was identified as the superior non-invasive diagnostic tool.

Conclusions:

• Headache alone can be the sole presenting symptom of a brain tumor.
• New-onset migraine in middle age may signify an underlying brain tumor.
• CT scans are essential for diagnosing brain tumors presenting with headache, regardless of cost concerns.