External Compression Headaches

Among the unusual headache syndromes, headache due to external compression is a poorly studied headache considered to arise as a result of continued stimulation of cutaneous nerves by the application of pressure over the scalp or forehead. The wearing of bands around the head, specifically goggles (such as those worn for swimming), tight hats, or even professional helmets have been described as causative factors.

The pain is often constant and more severe at the location where the object is pressing the head. In predisposed patients (i.e, those with migraine), external compression may lead to a more severe migrainous headache if the stimulus is prolonged. The mechanism responsible is the compression of trigeminal or occipital nerves branches. The headache resolves after pressure is relieved, or is prevented by avoiding the precipitating cause. Drugs are rarely used.

Symptoms:

The pain of external compression headaches is often described as moderate, constant pressure. It hurts most in the area where the object is pressing on your head. As long as the headwear is in place, the pain may get progressively worse.

Treatment:

To end your headache, remove the headwear that's causing the pressure. Further treatment is rarely needed. If you have a history of migraines, wearing tight headwear may trigger an attack that requires migraine medication for relief.

Statistics:

In a survey, 833 (72.6%) of the 1147 eligible persons completed the study protocol. One year prevalence rates were respectively 44.5% for TTH, 11.0% for MH (migraine headache), 2.2% for symptomatic headaches, and 0.7% for the remaining types of headache. The prevalence of headache in general was 51.0% because 62 residents had both TTH (tension-type headache )and MH attacks. Prevalence rates of patients with headache were higher in women than men (62.1% and 36.6% respectively) and decreased steadily with age for the 65–74, 75–84, and 85–96 age groups (56.7%, 45.2% and 26.1% respectively).