New-onset headache in an elderly man with uremia that improved only after correction of hyperphosphatemia ("uremic headache"): a case report

Sushil Razdan,Sanjay Koul,Vanilla Chopra,Kk Pandita

doi:10.1186/1752-1947-5-77

Abstract

IntroductionNew-onset headaches in the elderly are usually secondary and rarely primary. We present the case of an elderly man with recent-onset headache due to uremic hyperphosphatemia and hypocalcemia. To the best of our knowledge, this is the first case report of its kind in the literature.Case presentationWe present the case of a 70-year-old Indian man with chronic kidney disease whose new-onset headache improved only when his hyperphosphatemia and hypocalcemia were corrected. He had diffuse, dense calcification of tentorium cerebelli and falx due to hyperphosphatemia.ConclusionsThis case report reinforces the importance of identifying the cause of a new-onset headache, particularly in the elderly, and treating it before blaming a tension headache or primary headache as the cause.

Highlights

New-onset headaches in the elderly are usually secondary and rarely primary
This case report reinforces the importance of identifying the cause of a new-onset headache, in the elderly, and treating it before blaming a tension headache or primary headache as the cause
We present an elderly patient with chronic renal failure (CRF) with hyperphosphatemia whose new-onset headache improved only with correction of hyperphosphatemia and hypocalcaemia

Summary

Introduction

The prevalence of headache is reduced with age, it remains a common problem in the elderly [1]. For the past approximately one year, he had On examination, he had mild pallor, blood pressure of 130/88 mm Hg, and a sallow complexion. He had mild pallor, blood pressure of 130/88 mm Hg, and a sallow complexion The rest of his general examination and systemic examinations were unremarkable. His serum parathormone level was 321.1 pg/ml (NR, 15 to 68.3 pg/ml) His arterial blood gas analysis revealed no hypoxemia or hypercapnia. We administered tablets containing vitamin D and calcium His serum calcium level increased to 8.6 mg/dl, and the serum phosphate decreased to 5 mg/dl. He reported a remarkable improvement of his headache but would still have an occasional mild to moderate headache

Discussion

Findings

Conclusions

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