Photo Credit: Tharakorn

The following is a summary of “Anatomical and physiological contributions of nasal turbinate vessels and lymphatics to the pathogenesis of nasal congestion in recurrent headaches: A pilot study,” published in the January 2025 issue of Pain by Chmielecki et al. 

Researchers conducted a retrospective study to determine if specific anatomical changes were present in individuals with recurrent chronic primary headaches, including chronic migraines, chronic tension-type headaches, and daily persistent headaches.  

They analyzed data from 200 patients to evaluate nasal blood pool activity (nasal congestion) as a predictive marker for chronic recurrent headaches, including migraines, tension headaches, and unspecified headaches. A cohort analysis was performed on patients referred to the Nuclear Medicine Clinic over 3 years for whole-body blood pool scans. These scans were evaluated using region of interest (ROI) analysis of nasal and heart maximum pixel count ratios (NHMRs) to determine the association between nasal blood pooling activity and chronic recurrent headaches at the initial scan and in follow-up evaluations over 3-6 years.  

The results showed 122 patients with chronic headaches had higher NHMRs compared to those without chronic recurrent headaches at the time of the initial whole-body blood pool scan (P = 0.004; OR 10.5; 95% CI 2.22-56.7). An additional 15 patients developed chronic headaches after initial scan, bringing the total to 137, NHMRs in these patients were also significantly higher compared to those without headaches (P = 0.004; OR 12.3; 95% CI 2.34-75.5). These findings indicate that patients with chronic recurrent headaches exhibit increased nasal activity on 99m Tc-MDP whole-body blood pool scans, supporting the hypothesis that nasal lymphatic dysfunction contributes to the development of chronic headaches.  

Investigators concluded the whole-body blood pool scan provided a novel diagnostic approach for assessing nasal turbinate vasodilation and identified a potential new treatment target for chronic recurrent headaches. 

Source: frontiersin.org/journals/pain-research/articles/10.3389/fpain.2025.1521500/abstract