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Headache Caused by Sinus Disease.

Claudia F E Kirsch1

  • 1Department of Radiology, Northwell Health, Zucker Hofstra School of Medicine at Northwell, North Shore University Hospital, 300 Community Drive, Manhasset, NY 11030, USA.

Neuroimaging Clinics of North America
|March 31, 2019
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Summary

Many headaches attributed to sinus disease are actually migraines, often due to similar autonomic dysfunction. This guide uses the ACHE mnemonic to help clinicians differentiate sinus disease from migraines.

Keywords:
Autonomic dysfunctionLow-dose computed axial tomographyMagnetic resonance imagingMigraineSinusitisTrigeminovascular pathway

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Area of Science:

  • Otolaryngology
  • Neurology
  • Radiology

Background:

  • Headaches and sinus disease are prevalent global health issues with significant socioeconomic impact.
  • Distinguishing between sinus-related headaches and migraines is clinically challenging due to overlapping symptoms.
  • "Rhinogenic headaches" are often misdiagnosed migraines stemming from autonomic dysfunction and trigeminovascular pathways.

Purpose of the Study:

  • To provide a framework for differentiating headaches associated with sinus disease from migraines.
  • To equip radiologists, otolaryngologists, and neurologists with tools for accurate diagnosis.
  • To introduce the ACHE mnemonic for evaluating sinus disease and headaches.

Main Methods:

  • Utilizing the ACHE mnemonic: Anatomy, Clinical cases, How to image, Essential clinical and radiographic features.
  • Reviewing key anatomical structures relevant to sinus and headache pathways.
  • Analyzing clinical presentations and diagnostic imaging findings.

Main Results:

  • Headaches directly caused by sinus disease are rare; migraines are frequently misdiagnosed as such.
  • Autonomic dysfunction and trigeminovascular pathways contribute to symptom overlap.
  • The ACHE mnemonic facilitates the identification of distinguishing features.

Conclusions:

  • Accurate differentiation between sinus disease and migraine headaches is crucial for effective treatment.
  • The ACHE mnemonic offers a structured approach to diagnosis.
  • Multidisciplinary collaboration between specialists improves patient outcomes.