What is the classic description of brain tumor headache?
The classical brain tumor headache is commonly described as a severe early morning headache, associated with nausea and vomiting. The headache starts initially as episodic, and nocturnal, which usually awakens patients from sleep. As the tumor progresses, the headache becomes intermittent, then constant. It is influenced by position, most notably bending down or when recumbent. It is worsened with activities that increase intracranial pressure, such as cough, sneeze, emesis, and Valsalva maneuver. The headache is presumably expected to improve with ambulation. However, studies have demonstrated that few patients actually have the classical presentation of brain tumor headache, and as a result, morning headache that wakes patients up but improves during the day is not diagnostic.