Chronic headache related to nasal obstruction

Dor craniofacial e anormalidades anatômicas das cavidades nasais

“…Another mechanism related with the reported anatomical variations is the obstruction of drainage ostia of the paranasal sinuses, resulting in poor aeration, leading to vacuum headache or hypoxia 5,10,15,22 .…”

“…As to type and intensity of pain there are descriptions of intermittent pain 3,8 , with pressure characteristics 15,22 , pulsatile or sharp 9 , severe and disabling 9,22 , and many authors consider it mild to moderate 3 . As to location, inner canthus, supraorbital and frontal region 3,8,9,15,22 and it may reach the orbit 9 , infraorbital region and temporal-zygomatic region 8,22 , both unilateral 3 and bilateral, when it forms the fourfinger syndrome, in an allusion to the position taken by the victims of these symptoms 8,22 .…”

“…As to location, inner canthus, supraorbital and frontal region 3,8,9,15,22 and it may reach the orbit 9 , infraorbital region and temporal-zygomatic region 8,22 , both unilateral 3 and bilateral, when it forms the fourfinger syndrome, in an allusion to the position taken by the victims of these symptoms 8,22 . Other regions such as the vertex and the nape are also quoted 22 .…”

“…As to location, inner canthus, supraorbital and frontal region 3,8,9,15,22 and it may reach the orbit 9 , infraorbital region and temporal-zygomatic region 8,22 , both unilateral 3 and bilateral, when it forms the fourfinger syndrome, in an allusion to the position taken by the victims of these symptoms 8,22 . Other regions such as the vertex and the nape are also quoted 22 . The painful episodes normally last some hours 3,8 , with frequency varying from daily 9, 22 to weekly or rare 15 .The presentation may be related with level of nasal mucosa congestion, influenced by the position of the patient by the action of gravity 3,8,11,24 , and also by external stimuli, such as climatic affections 10 .…”

“…Such patients are diagnosed as having the pathology based on clinical data, according to the different characteristics presented above, and exclusion diagnosis has to rule out sinusal infectious, neurological and ophthalmic causes, and vascular and episodic headache, according to the report 3,9,11,22 . Therefore, for the diagnosis, such authors report the need of neurological assessment and investigation, including the attempt to treat, as well as by an ophthalmologist.…”