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Updated: May 11, 2026
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Dural Stimulation and Periorbital von Frey Testing in Mice As a Preclinical Model of Headache
Published on: July 29, 2021
Primary stabbing headache: a new dural sinus stenosis-associated primary headache?
S Montella1, A Ranieri, M Marchese
1Department of Neurosciences, Headache Centre, University Federico II of Naples, Pansini 5, Naples 80131, Italy.
Summary
Primary stabbing headache (PSH) is linked to sinus venous stenosis, a condition causing increased intracranial pressure. This suggests undiagnosed sinus stenosis-associated intracranial hypertension without papilledema may contribute to PSH development.
Area of Science:
- Neurology
- Vascular Neurology
- Headache Medicine
Background:
- Primary stabbing headache (PSH) is a headache syndrome of unknown cause, characterized by brief, severe jabs.
- PSH is often associated with other headache disorders, particularly migraine.
- Recent evidence suggests idiopathic intracranial hypertension without papilledema, linked to dural sinus stenosis, is more common than previously thought.
Purpose of the Study:
- To investigate the association between sinus venous stenosis and primary stabbing headache (PSH).
- To explore the potential role of sinus stenosis-associated intracranial hypertension without papilledema (ss-IHWOP) in PSH pathogenesis.
Main Methods:
- Retrospective investigation of patients diagnosed with PSH at a headache center since 2004.
- MR venography (MRV) was performed on 8 patients with PSH to assess for sinus venous stenosis.
- Clinical data including age of onset, attack duration, frequency, location, and treatment response were analyzed.
Main Results:
- All 8 patients who underwent MRV showed significant unilateral or bilateral sinus stenosis.
- The mean age at PSH onset was 35.3 years, with attacks lasting 1-3 seconds.
- Seven out of eight patients responded to indomethacin, and one to topiramate, both of which can lower cerebrospinal fluid pressure.
Conclusions:
- Primary stabbing headache (PSH) is associated with central sinus stenosis.
- These findings suggest that undiagnosed sinus stenosis-associated intracranial hypertension without papilledema (ss-IHWOP) may be involved in the development of PSH.
- Further research is warranted to confirm the role of ss-IHWOP in PSH and explore potential therapeutic implications.
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