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Headaches due to nasal and paranasal sinus disease

Stephen D Silberstein1

  • 1Thomas Jefferson University Hospital, Jefferson Headache Center, 111 South Eleventh Street, Suite 8130, Philadelphia, PA 19107, USA. Stephen.Silberstein@jefferson.edu

Neurologic Clinics
|April 6, 2004
PubMed

Insights

Sinus infections are uncommon but often overdiagnosed as a headache cause. True acute sinusitis presents with nasal discharge and specific pain, unlike common frontal headaches from migraine.

Area of Science:

  • Otolaryngology
  • Neurology

Background:

  • Sinus infections (sinusitis) are less prevalent post-antibiotics but frequently misdiagnosed as headache causes.
  • Acute sinusitis, an infection of cranial sinuses, presents with purulent nasal discharge and site-specific pain.

Purpose of the Study:

  • To clarify the diagnostic criteria for acute sinusitis and its role in headache etiology.
  • To address the overdiagnosis of sinusitis for headaches and the underdiagnosis of specific sinus infections.

Main Methods:

  • Review of clinical presentation and diagnostic challenges in sinusitis.
  • Differential diagnosis of headache, distinguishing sinus-related pain from other headache types.

Main Results:

  • Frontal head pain is more commonly associated with migraine and tension-type headaches than acute sinusitis.
  • Overdiagnosis of sinusitis for headaches occurs due to assumptions linking sinus area pain to sinus disease.
  • Sphenoid sinus infections are frequently missed, leading to underdiagnosis of sinus disease.

Conclusions:

  • Acute sinusitis is an uncommon headache cause and is often overdiagnosed.
  • Migraine and tension headaches are more frequent causes of frontal head pain.
  • Underdiagnosis of specific sinus infections like sphenoid sinusitis remains a clinical challenge.

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