Headaches and cerebral blood flow disturbances in patients with chronic nasal pathology

Study aimed at research of cerebral blood flow and blood NO contents in patients with chronic non-surgical nasal pathology with accompanying headaches. Eighty five patients with non-surgical chronic nasal pathology with accompanying headaches were investigated. Patients were divided in two age categories: 1st group of 58 patients (18 to 55 years), and 2nd group of 27 patients (>55 years). Control consisted of 30 age-matched healthy individuals. CBF was studied by means of Transcranial Doppler Imaging in patients and control. Free blood NO and NO - complexes were measured by Electron Paramagnet Resonance (EPR) method. Statistics performed by SPSS-11.0. In both age categories of patients the mean blood velocity in middle cerebral artery, anterior cerebral artery, basilar artery of patients was significantly increased against control (p<0.05). Pulsation index (PI) found to be decreased compared to control. The blood free NO signals were non-significantly increased against control. The intensive EPR signals of HbNO and FeSNO were revealed in patients and no signals were detected in control. No differences were revealed between clinical groups regarding the blood EPR signals of NO and NO-complexes (p<0.5). Negative correlation was found between the PI and intensity of headaches (r=-0.37; p<0.01). Multivariate linear regression analysis found the significance of longevity of chronic nasal pathology, Pulastion Index and blood hemoglobin contents for Intensity of headaches (p<0.05). It is concluded that CBF disturbances in chronic nasal pathology may result in intensive headaches.

Dopplerographic correlates of headaches accompanying the chronic nasal and nasopharyngeal pathology

The present study aimed at research of cerebral blood flow in patients with chronic nasal and nasopharyngeal pathology with accompanying headaches before and after appropriate treatment. One hundred and six patients with chronic nasal and nasopharyngeal pathology, aged from 6 to 75 years, 57 male and 49 female have been investigated. According to the type of nasal and nasopharyngeal pathology patients were classified in 5 groups, and were divided in three age categories: 6 -18 years (39 patients), 19- 65 years (38 patients), 66-75 years (29 patients). Headaches were estimated by neurologist before appropriate surgical and conservative treatment, after treatment and 6 months later. Cerebral blood flow was studied before treatment, after treatment and 6 months later by means of Transcranial Dopplerography. Control consisted of 30 age-matched healthy persons. Chronic headaches were established in 63 patients (59%). In all age categories the mean blood velocity in middle cerebral artery, anterior cerebral artery, basilar artery was significantly increased against control (p<0.05), and pulsation index (PI) found to be decreased compared to control. After treatment blood flow velocity in the middle cerebral artery, anterior cerebral artery and in basilar artery in all age groups did not differ significantly from control (p<0.5), and PI was significantly elevated against previous data (p<0.05). Cephalic pains disappeared in 75% of treated patients and 25% noted the significant decrease in pain intensity and frequency. Treatment of chronic nasal and nasopharyngeal pathology can prevent the certain kind of cephalic pains, and improve the clinical course of accompanying headaches.