In this report we present aspects of the epidemiology of
headache (i.e.,
pain in the head, face, ear, or neck) among children with
brain tumors. The data are derived from the 3,291 subjects in the Childhood
Brain Tumor Consortium databank. Overall, 62% of the children with
brain tumors experienced chronic or frequent
headaches prior to their first hospitalization: 58% of children with
supratentorial tumors and 70% of children with
infratentorial tumors. The relative frequency of
headache increased through age 7 and then leveled off regardless of
tumor location. For children under age 5,
headache rarely had a duration of more than 1 year prior to hospitalization. Among children over age 4,
headache duration of at least one year was significantly greater for supratentorial than for
infratentorial tumors. Children with a
brain tumor and
headache had a different distribution of symptoms and
neurologic signs than those without
headache.
Tumor location and
headache status were interactively associated with the presence of other symptoms and
neurologic signs. Children with
headache had a greater number of other symptoms and
neurologic signs. Regardless of
tumor location among children with
headache,
nausea or
vomiting,
papilledema, and hypoactive tendon reflexes were more frequent, while upper extremity weakness,
optic atrophy, and irritability were less frequent.
Diplopia,
coma, stiff neck,
anesthesia or
hypesthesia, pupillary abnormalities, and abnormalities of personality, academic performance, or speech were associated with
headache in children with
supratentorial tumors. No specific symptoms or
neurologic signs were associated with
headache in children with
infratentorial tumors. Supratentorial
craniopharyngioma,
ependymoma, and
protoplasmic astrocytoma were associated with significantly high rates of
headache as was infratentorial
pilocytic astrocytoma.