A 59-year-old woman with recent onset of epileptic seizures comes to the emergency department. On examination she presents left pyramidal signs and papillary edema. A brain MRI shows a right hemispheric mass with edema, midline deviation and signs of tentorial herniation. She reports that for the past week she has been suffering from headache that has been progressing in intensity. Which of the following features associated with headache seems most likely for this patient?
It is a headache in the context of papilledema. In this case the papilledema is due to increased intracranial pressure due to a tumor. The headache due to increased intracranial pressure is of positional type (it increases with Valsalva maneuvers and when bending down), so option 2 is not correct. In addition, it is predominantly morning (option 1 is correct) because in the morning intracranial pressure naturally rises. Migraine-type headaches may be associated with photophobia or sonophobia (answers 3 and 4). But this headache is not a migraine headache.
Morning predominance.
It does not change with effort.
Photophobia.
Sonophobia.
In addition, it is predominantly morning (option 1 is correct) because in the morning intracranial pressure naturally rises.
The headache due to increased intracranial pressure is of positional type (it increases with Valsalva maneuvers and when bending down), so option 2 is not correct.
Migraine-type headaches may be associated with photophobia or sonophobia (answers 3 and 4). But this headache is not a migraine headache.
Migraine-type headaches may be associated with photophobia or sonophobia (answers 3 and 4). But this headache is not a migraine headache.