Icepick headache

Icepick headache (or stabbing headache”) is a sudden pain on the scalp, such as a stab, sometimes excruciating and disabling but very short lasting (seconds or one minute). This pain occurs without alert ten or hundred times a day, on variable locations of the skull. It is freaking! This is generally a primary headache. The migraine patient seems more likely to present this type of pain. If it is possible to reproduce the pain with a moderate pressure on the scalp. If there are no other signs at the neurological examination, a brain MRI is not necessary. The diagnosis of icepick headache is clinical. Several triggers are described: stress; disturbances in sleep patterns or routine, red wine, hormonal changes. The cause remains unknown and we assume the role of peripheral (nerve endings of the scalp) and central (reverberation in brain circuits of pain) factors. The pain of the icepick headache is so short that there is no time for analgesic drugs. If the pain is frequent, consider taking drugs such as indomethacin or pregabalin. In conclusion, ice-headed headache is a benign primary headache. However, imagine yourself being hit regularly by an icepick on your head! Patients can be extremely worried. In our center we treat stabbing headache with mesotherapy.



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