tetano
Editor, Senior Moderator
Neurol Sci
. 2021 Jul 15.
doi: 10.1007/s10072-021-05444-3. Online ahead of print.
New daily persistent headache after SARS-CoV-2 infection: a report of two cases
Fedele Dono[SUP] #[/SUP][SUP] 1 [/SUP], Stefano Consoli[SUP] #[/SUP][SUP] 2 [/SUP], Giacomo Evangelista[SUP] 2 [/SUP], Maria D'Apolito[SUP] 2 [/SUP], Mirella Russo[SUP] 2 [/SUP], Claudia Carrarini[SUP] 2 [/SUP], Dario Calisi[SUP] 2 [/SUP], Matteo De Rosa[SUP] 2 [/SUP], Martina Di Pietro[SUP] 2 [/SUP], Maria Vittoria De Angelis[SUP] 3 [/SUP], Daniela Travaglini[SUP] 4 [/SUP], Stefano L Sensi[SUP] 2 [/SUP], Marco Onofrj[SUP] 2 [/SUP], Laura Bonanni[SUP] 5 6 7 [/SUP]
Affiliations
Abstract
Background: The 2019 Coronavirus (SARS-CoV-2) is a novel respiratory virus which causes Coronavirus Disease19 (COVID-19). Although the predominant clinical picture of COVID-19 is represented by respiratory symptoms, neurological manifestations are being increasingly recognized. Headache, in particular migraine-like and tension types, has been largely reported in patients suffering from COVID-19 both in the acute and the healing phase of the infection. New daily persistent headache (NDPH) is a primary headache characterized by persistent and daily painful symptoms, with pain becoming continuous and non-remitting within 24 h, and lasting more than 3 months. Even though an increasing number of reports describe patients who develop a persistent headache, diagnosis of NPDH has been rarely explored in the context of COVID-19.
Methods: Two patients with persistent headache and Sars-CoV-2 infection were identified. Both underwent a full clinical and neuroradiological evaluation. Blood sample with inflammatory biomarkers search was also performed.
Results: According to International Classifications of Headache Disorders diagnosis of probable new daily persistent headache was made. The treatment with high doses of steroids was associated with relief of symptoms.
Conclusions: Our report described two cases of probable NDPH due to SARS-CoV-2 infection. Clinical evaluation of COVID-19 patients presenting with persistent headache should take into consideration NDPH. Given the supposed major role for neuroinflammation in the genesis of Sars-CoV-2-driven NDPH, immunomodulatory therapy should be promptly started. In line with this hypothesis, we obtained a good therapeutic response to short-term high dose of corticosteroids.
Keywords: COVID-19; Headache; Immunotherapy; Neuroinflammation; Pandemic; Steroid.
. 2021 Jul 15.
doi: 10.1007/s10072-021-05444-3. Online ahead of print.
New daily persistent headache after SARS-CoV-2 infection: a report of two cases
Fedele Dono[SUP] #[/SUP][SUP] 1 [/SUP], Stefano Consoli[SUP] #[/SUP][SUP] 2 [/SUP], Giacomo Evangelista[SUP] 2 [/SUP], Maria D'Apolito[SUP] 2 [/SUP], Mirella Russo[SUP] 2 [/SUP], Claudia Carrarini[SUP] 2 [/SUP], Dario Calisi[SUP] 2 [/SUP], Matteo De Rosa[SUP] 2 [/SUP], Martina Di Pietro[SUP] 2 [/SUP], Maria Vittoria De Angelis[SUP] 3 [/SUP], Daniela Travaglini[SUP] 4 [/SUP], Stefano L Sensi[SUP] 2 [/SUP], Marco Onofrj[SUP] 2 [/SUP], Laura Bonanni[SUP] 5 6 7 [/SUP]
Affiliations
- PMID: 34264414
- DOI: 10.1007/s10072-021-05444-3
Abstract
Background: The 2019 Coronavirus (SARS-CoV-2) is a novel respiratory virus which causes Coronavirus Disease19 (COVID-19). Although the predominant clinical picture of COVID-19 is represented by respiratory symptoms, neurological manifestations are being increasingly recognized. Headache, in particular migraine-like and tension types, has been largely reported in patients suffering from COVID-19 both in the acute and the healing phase of the infection. New daily persistent headache (NDPH) is a primary headache characterized by persistent and daily painful symptoms, with pain becoming continuous and non-remitting within 24 h, and lasting more than 3 months. Even though an increasing number of reports describe patients who develop a persistent headache, diagnosis of NPDH has been rarely explored in the context of COVID-19.
Methods: Two patients with persistent headache and Sars-CoV-2 infection were identified. Both underwent a full clinical and neuroradiological evaluation. Blood sample with inflammatory biomarkers search was also performed.
Results: According to International Classifications of Headache Disorders diagnosis of probable new daily persistent headache was made. The treatment with high doses of steroids was associated with relief of symptoms.
Conclusions: Our report described two cases of probable NDPH due to SARS-CoV-2 infection. Clinical evaluation of COVID-19 patients presenting with persistent headache should take into consideration NDPH. Given the supposed major role for neuroinflammation in the genesis of Sars-CoV-2-driven NDPH, immunomodulatory therapy should be promptly started. In line with this hypothesis, we obtained a good therapeutic response to short-term high dose of corticosteroids.
Keywords: COVID-19; Headache; Immunotherapy; Neuroinflammation; Pandemic; Steroid.