Quiz Form

Question Date: 08/08/2023

Question: A 25 year old intern, working in the COVID ward complains of tightness around scalp without nausea or photophonophobia. It is especially prominent after covid duty, during which she wears a face shield and an N 95 mask. She denies prior migrainous headache<br><br>What is the diagnosis?

Options:

• Tension type headache
• External-pressure headache
• Migraine
• Nummular headache

Correct Answer: External-pressure headache

Explaination: External pressure headache is due to compression or traction on scalp from devices like helmets, CPAP masks, ponytails etc. During the Covid pandemic, 81 % of health care workers had new headache due to N95 mask or face shield and met criteria for external pressure headache. Headache is non throbbing without nausea or photophonophobia. External pressure may act as a trigger in a patient with migraine. Nummular headache is a localized, sharply demarcated scalp pain, more common in women.

Reference: Smith JH. Other Primary headache Disorders. Continuum202127(3 Headache)652-664.