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cold-stimulus headache (brain freeze)
Epidemiology:
1) occurs in 1/3 of population
2) may be more frequent in individuals with migraine
Pathology:
1) when cold liquid touches the hard palate, temperature sensors in the sphenopalatine ganglion cause blood vessel dilation, a response to increase heat delivery to the brain
2) the blood vessel dilation produces the headache
Clinical manifestations:
1) headache a few seconds afer eating cold/frozen food(s)
- peak sensation usually in 30-60 seconds
2) duration is generally about 10-30 seconds after cold stimulus removed, but may last 2-5 minutes
3) headache is generally mid-frontal, but may be temporal or retro-orbital (unilateral)
4) may occur more frequently, if not exclusively in warm weather
5) toothache may occompany headache
Management:
1) eat/drink cold items slowly
2) avoid contact of cold items with hard palate
3) a sip of warm beverage may hasten relief
4) pressing tongue to roof of mouth may hasten relief
General
headache
References
- Kaczorowski M, Kaczorowski J;
Ice cream evoked headaches.
Ice cream evoked headaches (ICE-H) study: randomised trial of
accelerated versus cautious ice cream eating regimen.
BMJ. 2002 Dec 21;325(7378):1445-6. No abstract available.
PMID: 12493658
- Hulihan J.
Ice cream headache.
BMJ. 1997 May 10;314(7091):1364.
PMID: 9161304
http://bmj.bmjjournals.com/cgi/content/full/314/7091/1364
- http://www.myslurpeecup.com/brainfreeze.html