Headaches Due to External Compression

Abstract

Headache is one of the most common types of recurrent pain in medical practice. Although nearly everyone has occasional headaches, there are well-defined headache disorders that vary in incidence and prevalence. Among the unusual headache syndromes, headache due to external compression is a poorly studied headache considered to arise as a result of continued stimulation of cutaneous nerves by the application of pressure over the scalp or forehead. The wearing of bands around the head, specifically goggles (such as those worn for swimming), tight hats, or even professional helmets have been described as causative factors. The pain is often constant and more severe at the location where the object is pressing the head. In predisposed patients (ie, those with migraine), external compression may lead to a more severe migrainous headache if the stimulus is prolonged. The mechanism responsible is the compression of trigeminal or occipital nerves branches. The headache resolves after pressure is relieved, or is prevented by avoiding the precipitating cause. Drugs are rarely used.

This is a preview of subscription content, access via your institution.

Fig. 1

References

Papers of particular interest, published recently, have been highlighted as: • Of importance

  1. 1.

    Scher AI, Stewart WF, Lipton RB: Migraine and headache: a meta-analytic approach. In: Epidemiology of Pain. Edited by Crombie IK. Seattle: IASP Press; 1999:159–170.

  2. 2.

    Rasmussen BK: Epidemiology of headache. Cephalalgia 1995, 15:45–68.

    CAS  PubMed  Google Scholar 

  3. 3.

    Headache Classification Subcommittee of the International Headache Society: The International Classification of Headache Disorders: 2nd edition. Cephalalgia 2004, 24 (Suppl 1):9–160.

    Google Scholar 

  4. 4.

    Olesen J, Goadsby PJ, Ramadan NM, et al., eds: The Headaches, edn 3. Philadelphia: Lippincott Williams & Wilkins; 2006.

  5. 5.

    Silberstein SD, Lipton RB, Dodick DW, eds: Wolff’s Headache and Other Head Pain, edn. 8. New York: Oxford University Press; 2008.

  6. 6.

    • Krymchantowski AV, Barbosa JS, Cvaigman M, et al.: Helmet-related, external compression headache among police officers in Rio de Janeiro. MedGenMed 2004, 6:45. This was the first paper describing external compression headache in a population of policemen, caused by wearing the specific uniform helmet.

    PubMed  Google Scholar 

  7. 7.

    Kharbanda P, Ganjoo RK, Chadha DS: A strange case of headache in a fighter aircrew: a case study. Indian J Aerospace Med 2008, 52:20–25.

    Google Scholar 

  8. 8.

    • Pestronk A, Pestronk S: Goggle migraine. N Engl J Med 1983, 308:226–227. This is an interesting article on ECH caused by wearing swimming goggles, perhaps the first reference pointing to this undercited cause of headache.

    CAS  Google Scholar 

  9. 9.

    Classification and diagnostic criteria for headache disorders, cranial neuralgias and facial pain. Headache Classification Committee of the International Headache Society. Cephalalgia 1988, 8 (Suppl 7):1–96.

  10. 10.

    Lance J, Goadsby PJ: Miscellaneous headaches unassociated with a structural lesion. In The Headaches, edn 2. Edited by Olesen J, Tfelt-Hansen P, Welch KM. Philadelphia: Lippincott Williams & Wilkins; 2000:752–753.

  11. 11.

    Rasmussen BK, Olesen J: Secondary headaches and their interrelations with primary headaches in a general population. In Headache Classification and Epidemiology. Edited by Olesen J. New York: Raven Press; 1994:149–154.

  12. 12.

    Nurmikko TJ, Jensen TS: Trigeminal neuralgia and other facial neuralgias. In The Headaches, edn. 3. Edited by Olesen J, Goadsby PJ, Ramadan NM, et al. Philadelphia: Lippincott Williams & Wilkins; 2006:1053–1062.

  13. 13.

    Rasmussen BK, Olesen J: Symptomatic and nonsymptomatic headaches in a general population. Neurology 1992, 42:1225–1231.

    CAS  PubMed  Google Scholar 

  14. 14.

    Mayo Clinic: External compression headaches. Available at http://www.mayoclinic.com/health/external-compression-headaches/DS00642. Accessed December 2009.

  15. 15.

    Beydoun A, Kutluay E: Oxcarbazepine. Expert Opin Pharmacother 2002, 3:59–71.

    Article  CAS  Google Scholar 

  16. 16.

    Cheshire WP Jr: Defining the role for gabapentin in the treatment of trigeminal neuralgia. J Pain 2002, 3:137–142.

    Article  PubMed  Google Scholar 

  17. 17.

    Lopez BC, Hamlyn PJ, Zakrzewska JM: Systematic review of ablative neurosurgical techniques for the treatment of trigeminal neuralgia. Neurosurgery 2004, 54:973–983.

    Article  PubMed  Google Scholar 

  18. 18.

    Mayo Clinic: External compression headaches. Available at http://www.ohiohealth.com/bodymayo.cfm?xyzpdqabc=0&id=6&action=detail&ref=2638. Accessed February 2010.

  19. 19.

    Lipton RB, Bigal ME, Goadsby PJ: Double-blind clinical trials of oral triptans vs other classes of acute migraine medication: a review. Cephalalgia 2004, 24:321–332.

    Article  CAS  PubMed  Google Scholar 

Download references

Disclosure

No potential conflicts of interest relevant to this article have been reported.

Author information

Affiliations

Authors

Corresponding author

Correspondence to Abouch Valenty Krymchantowski.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Krymchantowski, A.V. Headaches Due to External Compression. Curr Pain Headache Rep 14, 321–324 (2010). https://doi.org/10.1007/s11916-010-0122-x

Download citation

Keywords

  • External compression
  • Headache
  • Cutaneous nerves
  • Helmet