What are the other Names for this Condition? (Also known as/Synonyms)

• Headache Attributed to Leptomeningeal Carcinomatosis (LMC)
• Headache due to Carcinomatous Meningitis
• Headache due to Leptomeningeal Carcinomatosis (LMC)

What is Headache Attributed to Carcinomatous Meningitis? (Definition/Background Information)

• Headache Attributed to Carcinomatous Meningitis is a headache disorder that occurs secondary to carcinomatous meningitis, which develops as a result of seeding of the inner meningeal layers by malignant tumor cells (originating elsewhere in the body). Carcinomatous meningitis is also known as leptomeningeal carcinomatosis (LMC)
• Besides headaches, the condition may present cranial nerve palsy, altered mental status, seizures, and cognitive impairment. The nature and severity of the headache depends on the site of the carcinomatous meningitis. It is known to improve and regress on undertaking suitable management of the underlying neoplasia. Similarly, a progression of the condition in the absence of adequate treatment can worsen the headache
• Carcinomatous meningitis occurs during the advanced stages of any cancer; it is a rare complication with an unfavorable prognosis. The condition is diagnosed via cerebrospinal fluid (CSF) analysis and radiological studies. It is typically treated using a combination of radiation therapy and chemotherapy
• Sometimes, primary brain tumors can cause carcinomatous meningitis, including gliomas, ependymomas, and medulloblastomas. In a minority of cases (around 5%), the origin of the primary tumor may be indeterminate

The criteria for diagnosis of Headache Attributed to Carcinomatous Meningitis as outlined by the International Headache Society (IHS) is given below:

• Carcinomatous meningitis (in the presence of systemic neoplasia known to be associated with carcinomatous meningitis) has been demonstrated
• Any headache fulfilling the criterion below

Evidence of causation demonstrated by at least two of the following:

• Headache has developed in temporal relation to development of carcinomatous meningitis
• Either or both of the following:
  • Headache has significantly worsened in parallel with worsening of the carcinomatous meningitis
  • Headache has significantly improved in parallel with improvement in the carcinomatous meningitis
• Headache is associated with cranial nerve palsies and/or encephalopathy

Not better accounted for by another ICHD-3 diagnosis.

(Source: International Headache Society Classification ICHD-3, London, United Kingdom)