Headache Care Center, Springfield, MO 65807, USA.
Curr Pain Headache Rep. 2009 Aug;13(4):319-25. doi: 10.1007/s11916-009-0051-8.
Sinus headache is not a diagnostic term supported by the academia, yet it appears to be understood by the general public and larger medical community. It can be considered both a primary and secondary headache disorder. As a primary headache disorder, most of the patients considered to have sinus headache indeed have migraine (migraine with sinus symptoms). Yet it is also possible that some attacks of sinus headache may represent a unique clinical phenotype of migraine or be a unique clinical entity. Potentially, primary sinus headache can chronify and be refractory through immune-mediated mechanisms or as a catalyst for migraine chronification through ineffective treatment or medication overuse and misuse. As a secondary headache disorder, sinus headache can be associated with a wide range of underlying etiologies such as infection, anatomical abnormalities, trauma, and immunological disease or sleep disorders. It is possible that these underlying pathophysiological processes generate long-standing activation of nociceptive mechanisms involved in headache and can lead to chronification and refractoriness of the headache symptomatology. This article explores some of the potential mechanisms and the available scientific studies that may explain how sinus headache can become chronic and present to the clinician as a refractory headache disorder.
窦性头痛不是学术界支持的诊断术语，但它似乎为公众和更大的医学社区所理解。它可以被认为是原发性和继发性头痛障碍。作为原发性头痛障碍，大多数被认为患有窦性头痛的患者实际上患有偏头痛（伴有窦症状的偏头痛）。然而，也有可能一些窦性头痛发作可能代表偏头痛的独特临床表型，或者是一种独特的临床实体。原发性窦性头痛可能通过免疫介导机制而慢性化和难治，或者通过无效治疗或药物滥用和误用而成为偏头痛慢性化的催化剂。作为继发性头痛障碍，窦性头痛可与广泛的潜在病因相关，如感染、解剖异常、创伤和免疫性疾病或睡眠障碍。这些潜在的病理生理过程可能会导致参与头痛的伤害性机制长期激活，并导致头痛症状的慢性化和难治性。本文探讨了一些潜在的机制和现有的科学研究，这些机制和研究可能解释了窦性头痛如何变得慢性化，并向临床医生表现为难治性头痛障碍。
