Headache and Sinonasal Disease



Headache and rhinosinusitis are two of the most common conditions seen in clinical practice. Although headache is common in patients with sinus disease, recurrent disabling headache is usually due to migraine or a related disorder. Migraine frequently presents with symptoms such as frontal pressure, congestion, or facial pain which can mimic sinus pathology. Cluster headache and other trigeminal autonomic cephalalgias can cause significant autonomic symptoms, such as tearing, congestion, and rhinorrhea. Cluster headache is more common in tobacco users and in some cases can result from sinus pathology. Stimulation of the sphenopalatine ganglion is an emerging treatment for cluster headache. Contact point headache should be considered in patients with focal headaches and a contact point on the lateral nasal wall. Spinal fluid leak due to nasal disease may produce a low-pressure headache syndrome. Trigeminal neuralgia and other facial pains may be attributed to sinus disease, but proven nasal/sinus causes are unusual. Although most cases of frontal, maxillary, and ethmoid sinusitis are fairly easy to diagnose and not often confused with headache, sphenoid sinusitis is more commonly overlooked as a source of head pain and can present with progressive or thunderclap headache.


Cluster Headache Trigeminal Neuralgia Sphenoid Sinus Facial Pain Sinus Disease 
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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  1. 1.Department of NeurologyJefferson Medical College, Thomas Jefferson UniversityPhiladelphiaUSA

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