PubMed · 865234
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P Warot. 1977. [Headache. Introduction].. https://pubmed.ncbi.nlm.nih.gov/865234/
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The concept of sinus disease as a common cause of headache is deeply ingrained in the American public, but there is little evidence to support the sinuses as a common cause of disabling headache. On the other hand, a body of evidence supports the concept that migraine can present with facial pain and nasal symptoms such as congestion and rhinorrhea. In clinical studies nearly 90% of participants with self-diagnosed or physician-diagnosed sinus headache met criteria for IHS migraine-type headache and responded to triptan interventions in a manner similar to that witnessed in migraine. Consequently it is likely that most individuals seeking medical attention for sinus headache are, in fact, experiencing migraine. Nasal pathologic conditions, however, can also cause sinus headache. In general. other symptoms in addition to headache are also present, but there is clear symptom overlap among migraine, rhinosinusitis, and other nasal passage/sinus pathologic conditions, and further research is needed.
Medication overuse headache is a common complex disorder with physical and psychologic elements. Treatment may be difficult but often is accomplished in an outpatient setting. Some patients require inpatient treatments. An option for some is day treatment with i.v medication in an infusion center over several consecutive days. The two most common classes of drugs that acutely induce headache are NO donors, typified by NTG, and PDE inhibitors, typified by sildenafil. NO donors cause a biphasic headache in migraineurs and PDE inhibitors a monophasic one.
Vasculitis is a spectrum of clinicopathologic disorders defined by inflammation of systemic and central nervous system (CNS)arteries and veins of differing caliber with variable tissue injury. At the onset of systemic vasculitis, headache can occur in association with constitutional symptoms without imminent danger to the individual. In the advanced stages of systemic vasculitis and in selected other vasculitic disorders, headache should arouse suspicion of CNS involvement and therefore warrant prompt evaluation and treatment to forestall progression and prevent cerebral ischemia and infarction.