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. [ABSTRACT FROM AUTHOR]

Objetivo: Identificar si las características de la cefalea y sus síntomas y signos acompañantes se asocian a metástasis cerebrales en pacientes con cáncer sistémico. Material y Métodos: Pacientes con cáncer sistémico y cefalea vistos en un centro nacional de referencia entre junio 2012 y junio 2018 fueron incluidos. Se excluyeron pacientes con tumores primarios del SNC y con neoplasias hematológicas. Se realizaron regresiones logísticas simples y múltiples para medir la asociación entre las características clínicas y la presencia de metástasis cerebrales. Resultados: Se incluyeron 572 pacientes con cáncer y cefalea, de los cuales, 216 (38%) fueron diagnosticados con metástasis cerebrales. Las características asociadas con metástasis cerebrales fueron género masculino [Razón de momios (RM) = 1.9], cefalea que inició después del diagnóstico de cáncer (RM = 2.1), tipo opresivo (RM = 1.9), presencia de vómito (RM = 5.8), que la cefalea no incrementara con cambios en la posición (RM = 2.2), y localización generalizada (RM = 0.34). Adicionalmente, el presentar otro síntoma o signo además de la cefalea se documentó en el 73% de los pacientes con metástasis cerebrales y fue significativamente asociado con una mayor probabilidad de metástasis cerebrales (RM = 6.08); especialmente cuando presentaron alteración del estado de alerta (RM = 15), queja visual (RM = 15), déficit motor (RM = 11), convulsiones (RM = 15), ataxia (RM = 15), o vértigo (RM = 3.8). Conclusión: Al evaluar la posibilidad de tener el diagnóstico de metástasis cerebrales, el equipo encargado de la atención de los pacientes deberá considerar las características de la cefalea y los síntomas o signos acompañantes. [ABSTRACT FROM AUTHOR]

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