Which clinical history findings are characteristic of intracranial mass-related pediatric headaches?

Updated: Jan 02, 2019
  • Author: J Ivan Lopez, MD, FAAN, FAHS; Chief Editor: George I Jallo, MD  more...
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Distinguishing intracranial causes from extracranial causes of headache may be difficult. Patients with intracranial masses may complain of pain localized to the region of the mass. However, if a diffuse rise in intracranial pressure exists, the headache may be generalized.

Historical features of intracranial masses include the following:

  • Severe occipital headache

  • Sneezing, coughing, any Valsalva maneuver, or change in head position exacerbates the pain

  • Pain is worse in the morning or awakens the patient from sleep

  • Projectile vomiting without nausea and focal seizures may occur

However, morning headaches and projectile vomiting, once thought to be hallmarks of raised intracranial pressure, may also occur from etiologies other than intracranial masses.

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