Cause Of Headache Research Articles

Features of diving headache

WHO estimates that the prevalence of headaches worldwide in the adult population is approximately 50 %. Globally, half to three­quarters of people aged 18 to 65 have complained of headaches in the past year, and more than 30 percent have suffered from migraines. At the same time, 1.7 to 4 % of the adult population suffers from head­aches that last 15 or more days a month. Undoubtedly, cephalgia constitutes a global problem.However, it is worrying that the causes of headaches are not always correctly diagnosed. The main clinical barrier pointed out by WHO is the lack of knowledge of health pro­fessionals about headache management. Thus, the broad coverage of issues related to the management of patients with cephalgia does not lose its relevance, and even more: it needs to be supplemented with current data. In particular, the mechanisms of headache can be associated with several pathophysiological processes that are triggered by the in­fluence of professional activities, specific physical activity, active leisure, or amateur sports.Recreational diving has become a popular form of active leisure for the past 20 years. It is noteworthy that headache is a common symptom in divers and, although it is usually benign, it can sometimes signal the serious consequences of high pressure. Proper diagnostic tactics require specialists to carefully collect the anamnesis and examine the patient, as well as to understand the unique physiological changes in the human body that occur under the influence of under­water environmental factors.

ALCOHOL : A PROVOCATING FACTOR IN MALE CEREBRAL VENOUS THROMBOSIS – A PROSPECTIVE ANALYSIS IN WESTERN RAJASTHAN

BACKGROUND : Cerebral venous thrombosis is an uncommon cause of headache in our daily practice. However there is a need to identify its various provoking factors because timely and appropriate therapy can reverse the disease process , its acute complications and long term sequel. OBJECTIVE : To study the clinical prole in male Cerebral Venous Thrombosis patients . METHODS AND MATERIAL : This is a prospective cross sectional study of twenty ve male Cerebral Venous Thrombosis (CVT) patients diagnosed in outpatient clinic of neurology department at Dr S N medical college from the September , 2014 to august , 2018. Their ages ranged from 10 to 70 years with mean age of onset 31 yrs. All patients after taking informed consent with history suggestive of CVTand later diagnosed by imaging of brain ( MRI and MRV) were included. STATISTICALANALYSIS USED: All data were expressed as mean or patient's number (n) and percentage (%) as appropriate RESULTS: Among 25 male CVT patients , majority were young seen in 20-30yrs with mean age of 31yrs. Most common clinical presentation was headache [n=25(100%)] with or without vomiting followed by seizures [n=10 (40%)]. Most common site involved was transverse sinus [n=23(92%)]. Papilledema was observe in 21 patients (84%). Alcoholism [n=8 (32%)] and hyperhomocystenemia [n=6(24%)] were the risk factors seen in male CVT. CONCLUSION: Cerebral Venous Thrombois is found to be signicantly high in alcoholic males. Compared to other Indian studies there was not much disparity in clinical prole and risk factors.

Headache in Multiple Sclerosis - Pharmacological Aspects.

For decades, the headache was not considered a typical symptom of multiple sclerosis (MS) and was construed as a "red flag" for important differential diagnoses such as cerebral vasculitis. Meanwhile, several studies have demonstrated an increased prevalence of headaches in MS compared to the general population. This is due to the heterogeneity of headache genesis with frequent occurrence of both primary and secondary headaches in MS. On the one hand, MS and migraine are often comorbid. On the other hand, secondary headaches frequently occur, especially in the course of MS relapses. These are often migraine-like headaches caused by inflammation, which can improve as a result of MS-specific therapy. Headaches are particularly common in the early stages of chronic inflammatory CNS disease, where inflammatory activity is the greatest. In addition, headaches can also occur as a side effect of disease-modifying drugs (DMDs). Headache can occur with most DMDs and is most frequently described with interferon-beta therapy. The aim of this work is to present the prevalence of headaches and describe the heterogeneity of possible causes of headaches in MS. In addition, important therapeutic aspects in the treatment of MS patients, in general, will be presented as well as different approaches to the treatment of headaches in MS depending on the etiological classification.

Intracranial pressure monitoring: An unexpected diagnosis of obstructive sleep apnoea

We present the case of a 45-year-old man who underwent intracranial pressure monitoring for postural headaches. ICP results were unexpected with crescendo of overnight pressures and sudden drops. A diagnosis of sleep-disordered breathing, in the form of obstructive sleep apnoea was suspected. Sleep-disorderd breathing is known to cause rise in ICP [1-3]. We discuss the importance of identifying OSA as a potential cause of headaches, and ICP wave forms that may suggest a potential diagnosis of obstructive sleep apnoea. Keywords: intracranial pressure; intracranial pressure monitoring; obstructive sleep apnoea; sleep-disordered breathing.

Idiopathic Intracranial Hypertension: An Unusual Cause of Headache in a Patient With Sickle Cell Disease

Idiopathic intracranial hypertension (IIH) is a rare cause of headache and visual disturbance with no known association with sickle cell disease (SCD). We present a patient with SCD with gradual onset of a severe headache and visual changes. Brain magnetic resonance imaging, angiography, and venography were nondiagnostic. Lumbar puncture established a diagnosis of IIH, and the patient had rapid improvement with large-volume lumbar puncture and acetazolamide. To our knowledge, this is the first case of IIH in a nonobese adult with SCD taking hydroxyurea, suggesting an association between SCD or hydroxyurea use and IIH. Furthermore, her clinical course demonstrates the complexities of treating IIH in patients with SCD.

Pattern of Recurrent Pediatric Headache

Introduction: This study was conducted to provide detailed information about clinical characteristics and short-term treatment outcome of childhood headache. Materials and Methods: This prospective observational study was done over a period of 15 months (January 2013 to March 2014) at a rural tertiary care center in North India. Detailed history, clinical examination, specialty review, and follow-up details were maintained on pretested structured proforma. Final diagnosis of headache type was made as per International Classification of Headache Disorders, 2nd edition. Results: Out of 100 (45 boys) children aged 8–18 years, 52% were diagnosed with migraine, 23% with tension-type headache, and 25% with secondary headache. Diffuse headache was the commonest (41%), and photophobia, phonophobia, and dizziness were the commonest symptoms in all headache subtypes. Sixty-five percentage of migraine headache were triggered by exertion. Lack of sleep and anxiety were triggers in most (65%) of tension type headache. Of 52 migraine children, 21 were started on prophylaxis for migraine and 14 of them reported significant improvement. Secondary causes for headache were found in 25% of children and half of them were having refractive errors. Conclusions: Results of the study show migraine being the commonest type of headache in children followed by secondary headache. This study also highlights the need for long-term follow-up of childhood headache.

Assessment of Appropriateness of Doing CT Scan for Investigating Headache in a Tertiary Care Hospital in Eastern India

Background: Headache is one of the most common presenting symptoms encountered in day to day clinical practice.A computed tomography is often the most common imaging modality to diagnose the underlying causes of headache,majority of which turns out to be normal. The objective of this research is to study the morbidity patterns in the CT scanreports of patients presenting with headache in the population attending a tertiary care hospital in Eastern India.Method: The study was a retrospective analysis of all the CT scan reports performed in a tertiary care government hospitalperformed for diagnostic evaluation of headache referred from different clinics and included all patients regardless of theage during the time period December 2018 to November 2019.Results: All the patients were classified into two groups traumatic and non- traumatic depending on the history. Out ofa total 1142 patient evaluated, 649 patients (56.83%) did not yield any positive findings on CT scan, i.e. the reports werenormal. In fact, a routine CT scan is not advised for all headache complaints even by the ACR (American College ofRadiology) appropriateness criteria. The difference between the number of patients with normal CT scan and abnormalCT scan in both the groups was statistically significant (p< 0.05).Conclusion: In concordance with the previous similar studies, it may be concluded that in evaluation of headache, CTscan should be advised only in selected cases as recommended by ACR Appropriateness Criteria® Headache or any otherguidelines that may be developed for this purpose.

Endoscopic Treatment of Rhinogenic Contact Point Headache-Our Experiences at a Tertiary Care Teaching Hospital of Eastern India

Background: Headache is a universal clinical presentation in the course of everyone's life. In Rhinogenic contact point headache (RCPH), intranasal mucosal contact points are seen between the opposing mucosal surface of the nasal septum and turbinates of the lateral wall of the nasal cavity. Objective: To study the details of endoscopic treatment of RCPH and its effectiveness to relieve headache. Materials and Methods: There were 68 patients of RCPH who participated in this prospective study. The mucosal contact points inside the nasal cavity were excised by the endoscopic approach under general anesthesia. The olfactory mucosal lining was protected from injury during this surgical process. P < 0.05 were considered statistically significant. Results: Out of 68 patients with RCPH participated in this study with 38 (55.88%) males and 30 (44.11%) females with a male-to-female ratio of 1.26:1. All patients underwent endoscopic excision of the intranasal mucosal contact points. After 3 months of endoscopic excision of the intranasal mucosal contact points, the symptoms disappeared in 52 (76.47%) patients, and significantly improved in 13 (19.1%) patients. Only 3 (4.41%) patients did not show obvious improvement. Satisfactory results were archived by endonasal excision of the mucosal contact points in 65 (95.58%) patients with RCPH. Conclusion: RCPH is an important cause of headache. Endoscopic surgical excision of the intranasal mucosal contact points in patients of RCPH is useful to relieve headache effectively.

Effects and side effects of migraine prophylaxis in children.

Migraine is the primary cause of headache in children. Most patients can be treated with lifestyle changes and acute attack prophylaxis. Prophylaxis should be considered when symptoms cause frequent school absenteeism, poor quality of life, recurring emergency room visits, and frequent analgesic use. We aimed to compare the efficacy and side effects of drugs used in migraine prophylaxis, chosen according to the clinical and/or demographic characteristics of the patients. One hundred eighty-six patients aged 6-18 years were evaluated and who were diagnosed with migraine according to The International Classification of Headache Disorders, 3rd edition beta version (ICH-3β). Propranolol, topiramate, flunarizine, and cyproheptadine were given as prophylactic treatment. The Pediatric Migraine Disability Assessment Score (PedMIDAS) score, severity, duration, and frequency of the headache attacks were evaluated from the medical records and pre- and post-treatment values were compared. The median age of the patients was 14 years (range, 6-18 years) and the mean duration of headache was 29.6 ± 21.02 months. The mean PedMIDAS score was 29.9 ± 21.2 before and 14.9 ± 12.5 after treatment. Most reduction in the frequency of attacks was observed in the topiramate group. All four drugs significantly reduced the PedMIDAS score. The most common side effect was palpitations. Significant improvement was found in PedMIDAS scores in all drug groups. Topiramate was found to be the most effective drug in reducing the frequency of attacks. All four drugs in this study may be utilized for migraine prophylaxis in terms of effectiveness and safety.

An unusual Cause of Persistent Frontal Headache in a 9-Year-Old Boy

Headache is a common clinical experience of the patients and is found in all age groups. Intranasal mucosal contact with the absence of inflammation in the nasal cavity and paranasal sinuses may cause a secondary headache which is called a rhinogenic contact point headache (RCPH). RCPH is currently a topic of interest among clinicians and is accepted as a cause of headaches by the International Headache Society Classification. The diagnostic nasal endoscopy showed an S-shaped deviated nasal septum with intranasal mucosal contact in both nostrils. The headache of the child was disappeared after performing septoplasty and excision of the bilateral mucosal contact points. These anatomical variations in the nasal cavity in the pediatric age with bifrontal headache is a very rare clinical entity. Hence, clinicians and pediatricians should keep in mind RCPH during the evaluation of headaches in a pediatric patient. In this case report, a 9-year-old boy presented with a persistent bifrontal headache due to mucosal contact points in the nasal cavity.

Rhinogenic contact point headache in pediatric age group: a review

Headache is a common clinical entity of pediatric patients in routine clinical practice. Anatomical variation in the nasal cavity may result in headaches due to contact of the opposing mucosal surfaces, called rhinogenic contact point headache (RCPH). RCPH has recently begun to be of interest among clinicians and is accepted as a cause of headache by international headache society classification. The pressure of the two opposing mucosal surfaces in the nasal cavity without any evidence of inflammation can be an etiology for headache or facial pain. Anatomical variations in the nasal cavity like deviated nasal septum (DNS), spur, concha bullosa, hypertrophied inferior turbinate, medialized middle turbinate, and septal bullosa are important causes for contact point headache. RCPH is often misdiagnosed by clinicians during the assessment of headaches in pediatric patients and is sometimes considered a headache of unknown etiology. Endoscopic examination of the nasal cavity and computed tomography (CT) scans are important tools for the diagnosis of anatomical variations in the nasal cavity causing RCPH. Endoscopic resection of the contact point in the nasal cavity is the treatment of choice. There is not much literature for RCPH in pediatric patients, indicating that these clinical entities are neglected. This review article discusses the details of the epidemiology, etiopathology, clinical manifestations, diagnosis, treatment of the RCPH in pediatric patients.

Migraine in children and adolescents: modern principles of diagnostics and treatment

Migraine is a nervous system disorder that affects 7.7% of children and can debut before the age of 3 years. As they get older, the incidence of migraine increases, and among adolescents, its prevalence reaches 15%. The disease can significantly reduce the child's daily activity, school performance. Migraine is the most common cause of headache in children and adolescents, but it is not always diagnosed; it is not uncommon for patients with migraine to be misdiagnosed and given ineffective treatment. An effective approach to the diagnosis of migraine in children is presented, diagnostic criteria for migraine according to the 3rd edition of International Classification of Headache Disorders are described. Special disorders in childhood are described – episodic syndromes in children associated with migraine. Migraine treatment in children includes four main approaches: 1) lifestyle recommendations; 2) migraine attack treatment; 3) nonpharmacological treatment; 4) migraine preventive pharmacotherapy. All of the listed approaches for the treatment of migraine in childhood are discussed in detail.

Iatrogenic Pneumocephalus Resolved by Oxygen Therapy

Iatrogenic pneumocephalus and dural puncture are some causes of headache following cervical epidural injection. A 50-year-old woman presented with a sharp headache at the base of her skull following a cervical epidural injection for chronic neck pain. It was not relieved by lying down and was associated with nausea, vomiting, and photophobia without fever or neck rigidity. Neurological examination failed to show any abnormalities. A head CT scan showed newly evident pneumocephalus in the ventricular system and the extra-axial subarachnoid space within the sulci of the right frontal lobe. Oxygen supplementation was started with the help of a non-rebreather mask connected to 15 liters of oxygen and was slowly down titrated to room air. Repeat CT scan of the head after 48 hours showed complete resolution of the intracranial pneumocephalus. Normobaric oxygen therapy via a non-rebreather mask and a high-flow nasal cannula is effective for the treatment of intracranial pneumocephalus.

Characteristics of headache in vertebral artery dissections

Purpose: A vertebral artery dissection (VAD) is a rare disorder that can masquerade as musculoskeletal head and/or neck pain and requires an urgent medical referral. If the diagnosis is missed or mismanaged it can progress to stroke and death. Headaches are one of the main symptoms of a VAD that precedes ischaemic signs. The aim of this systematic review is to identify the common features of VAD headaches to ascertain if key characteristics can aid differentiation from other less sinister causes of headache with musculoskeletal origin.

Migraine headache in Sudan.

BackgroundMigraine is a main form of headache, it is also a chronic and complex neuroinflammatory disease; it is characterized by recurrent severe headaches, usually affecting one side of the head, and often accompanied by nausea and blurred vision. In susceptible individuals, irritants can trigger migraine attacks, which can be considered as triggers or accelerators.ObjectiveTo describe the precipitating factors, clinical presentation, and treatment of migraine headache in Sudanese patients.MethodsThis is a descriptive hospital‐based prospective study covering 130 patients during the study period from January 2016 to December 2018. At the National Centre for Neurological Science, Khartoum, participants were Sudanese patients with migraine headache after exclusion of other causes of headache. Data was collected using structured questionnaire entered and analyzed using SPSS version 22.0, p value < .05 is considered significant.ResultsThe study covered 130 study participants most of them were females (80%), within 26–35 years of age (56.9%) and a considerable proportion of them were housewives (40%). The majority of the study participants had headache without aura in 81.5% and headache with aura in 18.5% (mainly visual type 87.5%). Photophobia and nausea were the main associated symptoms in 51.5% and 50%, respectively. Acetaminophen was the main prescribed treatment in 46.1%, beta blockers was the main prophylaxis in 29.2%. Environmental triggers were the prevalent predisposing factors (43.8%) followed by fasting, lack of sleep, and exertion (24.6% for each).ConclusionEnvironmental conditions were the commonest triggering factors of migraine headache, while Acetaminophen was the most common drug used for relieving migraine in this population.

Evaluation of headache associated with personal protective equipment during COVID-19.

BackgroundThe COVID‐19 pandemic has created new conditions for medical staff, forcing them to use personal protective equipment (PPE) for an extended duration of time. Headache is a commonly associated side effect of the use of such equipment among healthcare workers.MethodIn this cross‐sectional study, 243 frontline healthcare workers at four referral hospitals for COVID‐19 were evaluated for the occurrence of headache following the use of PPE and its relationship with blood gas parameters was assessed.ResultsThe average age of participants was 36 ± 8 years. Of these, 75% were women. The prevalence of headache after the use of masks was 72.4%, with the N95 mask being the most commonly reported cause of headache (41%). Among patients, 25.1% developed external pressure, 22.2% migraine, and 15.2% tension‐type headaches. Headache was more common in the female gender. Apart from gender, only increased heart rate was significantly associated with headache due to mask use (p = .03 and .00, respectively). The mean heart rate was 97.7 ± 13.68 in participants with headache compared to 65.8 ± 35.63 in those without headache. No significant relationship was found between headache and venous blood gas parameters, including oxygen and carbon dioxide partial pressure.ConclusionHeadache due to PPE is common and can decrease the efficiency of hospital staff performance. Hence, it is necessary to consider this issue among health center personnel and provide modalities to reduce the risk of headache.

Ophthalmic Causes of Headache among Patients Attending Tertiary Care Center in Kathmandu, Nepal

The purpose of this study was to evaluate the ophthalmic causes of headache among patients attending tertiary care hospital. This was a descriptive, cross sectional hospital-based study. One hundred and thirty-two patients with ocular cause of headache excluding primary headache and pediatrics patients during one year were included. Detail ocular examination was done including visual acuity, refraction, binocular vision assessment like convergence insufficiency and fusional insufficiency, anterior and posterior segment examination. Among headache patients, female was 106 (80.3%) and male was 26 (19.7%). The prevalence of headache in female was 6.9% and in male was 2%. Headache was more common in age group 18-29 (59.8%). The mean age of presentation was 29.9 ± 10.2 years (range 18-61 years). Out of 132 patients with headache, 104 (78.8%) had refractive error, 15 (11.4%) had fusional insufficiency, 6 (4.5%) had convergence insufficiency, 10 (7.6%) had anterior segment diseases and 5 (3.8%) had posterior segment diseases. Among refractive errors, both eyes astigmatism was the commonest 48 (36.5%) followed by both eyes simple myopia 44 (33.4 %) which was statistically significant with ocular headache (p=0.000). Ocular anomalies other than refractive error may coexist with headache complaints. Therefore, thorough ocular examination should be done in all patients suffering from headache.

Selection of headache cases for expedited scanning to assist prompt diagnosis of brain tumour

Abstract Aims Patients with brain tumours and headache commonly have poorer cognitive skills, either overtly or covertly, when cognitively tested. Cognitive changes reflect, tumour mass, fronto-temporal location or hydrocephalus, Previous work has demonstrated that the “semantic Verbal Fluency Test (SVFT) -“How many animals can you think of in a minute?” is a useful fast screening test for cognitive issues. Median SVFT in patients with brain tumour on admission is 10 animals. Most GPs can now order “direct access cerebral imaging (DACI)” in patients with headache suspicious of cancer. The waiting times for scanning can be many weeks. The aim of this study was to determine whether low SVFT scores: might be useful to help stratify or expedite DACI. We present data from referrals through and electronic Protocol Based Referral (PBR) pathway for CT scanning over 3 years, to determine whether SVFT might be a useful adjunct to history and examination. Method From 2017, in Edinburgh/Lothians, Scotland, an electronic PBR was developed with involvement of Primary Care Cancer Lead, PBR lead, Neurology, Neurosurgery and Neuro-Imaging for outpatient imaging of patients in the community with Headache Suspicious of Cancer, to expedite their scans. The PBR sat alongside the routine outpatient DACI system. If the forms were correctly filled in Neuro-Radiology prioritised their appointments. The referrer (GP) was asked to complete the ePBR form and SVFT at the time of referral. Other data were also gathered, including: Past Medical History of cancer; other symptoms/signs; and co-morbid conditions and medications filled automatically from the GP system. This formed the dataset. We also retrospectively assessed a) whether English was first language b) past history of Pain Clinic Attendance or Functional Illness and subsequent final diagnosis of headache/condition, through evaluation of electronic GP referral letters through SCI Gateway system of those cases where SVFT was recorded. Results Between March 2017 - November 2019, 669 scans through PBR pathway. (62% females; Mean age 53 years: 60% cases &amp;lt;60 years). SVFT was completed in only 381/669 (57%). Median SVFT was 17. Eleven of 381 cases had cancer (2.9%). 10 cases with cancer had SVFT &amp;lt;17 animals (median 10) (5.32%). One case had SVFT &amp;gt;=17 (35 animals) (0.5%) - CT scan showed small multiple intra-cerebral calcified and non-calcified lesions, consistent with metastases. 12% with PMH cancer had a tumour. Other possible reasons for low SVFT were: co-existing presumed dementia/mild cognitive impairment (19); non native English speakers (12); headache after traumatic brain injury (5); significant small vessel disease/vascular(5); intracranial cysts (4)(pineal / arachnoid, Giant Cell Arteritis (4) (all new - symptomatic); Chiari 1 malformations (2), PMH – encephalitis (1). Interestingly, there were 53 cases with known psychiatric/pain conditions on drugs (e.g. codeine/antidepressants/antipsychotics) with SVFT &amp;lt; 17 words/min. Conclusion People with Headache "Suspicious of Cancer" + SVFT &amp;lt;17 words in a minute are more likely to have a tumour (5.32% vs 0.5%) or other secondary cause for poor cognition. Other probable causes /associations, with SVFT &amp;lt;17 are age, poor English skills, co-existing dementia. SVFT score may be a useful adjunct or “red flag,” to consider, to expedite DACI scan in patients with “Headache Suspicious of Cancer”. A SVFT &amp;gt;=17 in those with Headache Suspicious of Cancer, does not exclude the possibility of an intracranial tumour. Excluding cases with recognised causes for low SVFT e.g. dementia and those with existing chronic pain/psychiatric disease further increases the likelihood of a secondary cause for headache. SVFT should be tested in the persons native language. A larger prospective study is required to establish whether these pilot study data and to examine whether chronic pain, functional neurology are negative predictive factors for secondary headache.

Current Understanding of the Pathophysiology and Approach to Tension-Type Headache

Description of headache dates back thousands of years, and to date, tension-type headache (TTH) remains the most common form of headache. We will review the history and current understanding of the pathophysiology of TTH and discuss the recommended clinical evaluation and management for this syndrome. Despite being the most prevalent headache disorder, TTH pathophysiology remains poorly understood. Patients with TTH tend to have muscles that are harder, more tender to palpation, and may have more frequent trigger points of tenderness than patients without headache. However, cause and effect of these muscular findings are unclear. Studies support both peripheral and central mechanisms contributing to the pain of TTH. Diagnosis is based on clinical presentation, while the focus of evaluation is to rule out possible secondary causes of headache. Treatment options have remained similar over the course of the past decade, with some additional studies supportive of both pharmacological and non-pharmacological options. An approach to TTH has been outlined including historical context, evolution over time, and the best evidence regarding our current understanding of the complex pathophysiology and treatment of this disease.

Rhinogenic Contact Point Headache in Pediatric Age

Background: Headache is a common clinical entity seen among pediatric patients in routine clinical practice. The pressure of two opposing mucosa in the nasal cavity even in the absence of inflammation can be a cause of headache, which is called a rhinogenic contact point headache. Anatomical variations of the nose such as rhinogenic contact point headache may result in headache due to the contact of the nasal mucosa which often missed during the evaluation of the pediatric patients. Objective: The aim of this study is to assess the rhinogenic contact point headache in the pediatric age group. Materials and Methods: This is a prospective study and 112 children with rhinogenic contact point headache enrolled in this study. This study conducted at a tertiary care teaching hospital during September 2018–October 2021. The anatomical variations of the nose were evaluated with help of diagnostic nasal endoscopy and computed tomography (CT) scan. These anatomical variations in rhinogenic contact point headache were treated surgically. Results: Out of 112 children with rhinogenic contact point headache, 31 (27.67%) had deviated nasal septum, 28 (25%) had septal spur, 20 (17.85%) middle turbinate concha bullosa, 11 (9.82%) enlarged ethmoidal bullosa, 11 (9.82%) had hypertrophied inferior turbinate, 7 (6.25%) had hypertrophied super turbinate, and 4 (3.57%) had nasal septal bullosa. Treatment of each child with rhinogenic contact point was personalized for every patient. Conclusion: Headache is a common clinical symptom and is nearly universal in the life of a child. The contact between opposing mucosa in the nasal cavity in the absence of inflammation can result in headache and/or facial pain in the pediatric age group. Endoscopic excision of the contact points of nasal cavity is effective for the treatment of rhinogenic contact point headaches.