Objective:

The objective of the study was to identify if headache characteristics and accompanying signs or symptoms are associated with brain metastases (BM) in patients with non-central nervous system (CNS) cancer.

Materials and Methods:

Patients with systemic cancer and headache seen at a single center between June 2012 and June 2018 were included in the study. Hematologic or primary CNS tumors were excluded from the study. Simple and multiple logistic regression analyses were used to measure associations with BM.

Results:

From 572 patients with cancer and headache, 216 (38%) were diagnosed with BM. Characteristics associated with BM were male sex [odds ratio (OR) = 1.9], headache starting after cancer diagnosis (OR = 2.1), oppressive type (OR = 1.9), presence of vomiting (OR = 5.8), not increased by changes in position (OR = 2.2), and generalized location (OR = 0.34). In addition, having another symptom/sign other than headache was seen in 73% of patients with BM and was significantly associated with higher odds of BM (OR = 6.08), especially if patients presented with altered mental status (OR = 15), visual complaint (OR = 15), focal motor weakness (OR = 11), seizures (OR = 15), ataxia (OR = 19), or vertigo (OR = 3.8).

Conclusion:

To assess their odds of being diagnosed with BM, the attending team should consider the characteristics of the headache and any accompanying symptoms and signs.

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