New Acute Headache – ? Cause

Eliminating chronic headaches and “cephalic illnesses” (stroke, seizures, cranial lesions, sinusitis, or central nervous system infections” left a group with new moderate- severe headaches that attended emergency. These people could have comorbid serious health issues such as heart failure, worsening asthma or  emphysema, hypertension and pneumonia or something as trivial and an acute viral illness.

Tzadok, Tomer, et al.
Headache in the presentation of noncephalic acute illness.
Journal of neurosciences in rural practice 6.4 (2015): 494.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4692004/

199 patients with following causes:

  • CHF 19.0%
  • COPD exacerbation 17.5%
  • pneumonia 7.7%
  • URTI (cold) 11.9%
  • Asthma exacerbation 10.8%
  • UTI (bladder infection) 9.3%
  • hypertension  7.7%
  • fever of undetermined cause 16.0% ?viremia

They found association with higher temperature and platelets (degranulating platelets are incriminated in migraine attacks).

Comment – One lung infection illness has been found associated with chronic migraines – Chlamydia pneumonia (no, it is not a VD).

Association Between Chlamydia pneumoniae  and Migraine: A Study from a Tertiary Center in India
Jaydip Ray Chaudhuri et al
J Oral Facial Pain Headache 2016;30:150–155.
doi: 10.11607/ofph.1570

In chronic headaches they found associated:

After adjustment for multiple logistic regression analyses,

  • C pneumoniae IgG antibody positivity (odds ratio [OR] 2.6
  • CRP (sign of systemic inflammation) positivity OR 6.2
  • mild depression OR 16.9 (that is very high) – making me think this is often and inflammatory issue
  • sleep disturbance OR 2.1

One wonders if C. Pneumonia infection was a possibility in those with exacerbation copd or asthma. People who run low platelets might be pleased – maybe they run less headaches? In an emergency setting –  lung issues, bladder infections and hypertension need to be ruled out.

I have people who say they have a persistent cold and want me to work it out. If not allergies, I ask them if they remember having a headache in the past week – heralding a new cold they did not recognize as such. Other causes mentioned could include:

  • sinusitis
  • otitis media
  • hypoglycemia
  • hypothyroidism
  • dehydration

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