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The presence of endonasal pathological conditions or headache accompanying symptoms involving the nose, show a bi-directional link between the latter and endocranial structures. Instrumental diagnostic procedures allow demonstration of anatomical variants of the bone. Frequently, surgical procedures addressed to correct such variants seem to resolve both headache and breathing disturbances. However, hyperactivity of nasal mucosa and microcirculation might be responsible for cephalic disturbance as a consequence of activation of neuro-vascular systems (trigeminal, sympathetic, parasympathetic) and explain both pain and attendant accompanying symptoms during migraine and cluster headache attacks. Peripheral triggering or aggravating factors may, therefore, be responsible for or, at least, contribute to pathophysiological mechanisms of certain headaches.