full brain radiotherapy

Hi,
I really hope you will be able to provide an answer to my question. I was diagnosed with breast cancer in 2003, had surgery, chemotherapy, radiotherapy and herceptin, I was then given the all clear. However, in May 2008 I was diagnosed with a secondary brain tumour, again had surgery and rfull brain adiotherapy. Recent scans have all been clear but I am still experiencing really bad headaches? More often than not analgesics do not get rid of the pain. Could you shed some light on why I am still getting these headaches and the best way to deal with them.

thanking you in acitipation

[Neuro Forum]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with your doctor.

Without the ability to examine you and obtain a history, I can not tell you what the exact cause of your symptoms is. However I will try to provide you with some useful information.

One condition that comes to mind in someone with headaches following brain surgery is called benign intracranial hypotension. In this condition, a very small leak of the fluid that surrounds the brain (called CSF) occurs, leading to too low of a pressure. The headaches related to this condition classically improve when the person lies down and gets worse when the person sits or stands. A much less likely cause given that your symptoms have been going on for several months is an infection. Post-craniotomy headaches, or headaches occurring after brain surgery, are not uncommon and in some patients can persist for months. There are many potential causes to such headaches. In addition, though rare, whole brain radiation can lead to headaches months after treatment as well.

I recommend that you discuss your headaches with your oncologist. Referral to a neurologist for further management of your headaches is recommended; referral to a headache specialist (a neurologist with a subspecialty in headaches) may be particularly useful if you have one in your area.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.