Headaches of Nasal Origin

Related entries: Headache: ElTh-links

There are no more distressing headaches than those which come from disease within the nasal passages, in the acute form of these headaches, the distress is through the eyes, at the root of the nose, or perhaps in one orbit, or through the temples. In chronic cases, the pain involves the temples and the area at the base of the brain, and occasionally it is located at the base of the skull, in the occipital region, apparently involving the muscles of the neck. Occasionally there will be a tenderness on pressure in this locality and I have observed many cases where the back of the neck was very cold, and persistently so as long as the headache lasted.

Dr. A. I. Weil in The New Orleans Medical Journal believes that diseases of the nose, which give rise to headaches, may be divided into three distinct groups. 1st. Those which cause obstruction to nasal respiration resulting in mouth breathing, especially at night, impaired oxygenation, etc.; to this class belong chiefly turgescence and moderate hypertrophy of the turbinates, especially the inferior and certain polyps, which hang down from the middle meatus and obstruct the air passage. 2nd. Deformities or disease, which cause pressure within the nose, such as hypertrophied middle turbinates, large spurs of the septum and the like; and 3rd. Acute or chronic catarrh or suppuration of the nasal mucous membrane of the accessory cavities, for example, acute coryza and acute sinusitis. The pain is to be attributed usually to one of five causes:

(1) Pressure of the hypertrophied or swollen part upon the septum or upon each other, especially the middle turbinate against the septum.

(2) Hyperesthesia of the mucous membrane.

(3) Acute congestion or inflammation of the Schneiderian membrane.

(4) Retention of pus under pressure.

(5) Disturbance of the blood and lymphatic circulation at the base of the skull; this latter applies especially to adenoids and lies outside the scope of the present paper.

Ellingwood's Therapeutist, Vol. 2, 1908, was edited by Finley Ellingwood M.D.