Nummular Headache in a Young Nigerian Man-Associated with History of Load Carrying on the Head

Abstract

Nummular Headache (NH) is a rare headache disorder characterized by sharply contoured pain fixed in size and shape within a round or elliptical region of the head. We present  Mr EAO, a 25 year old young man who presented with a history of recurrent well-circumscribed headache of about 7 years duration over a circular area on the vertex of the head measuring, 3.0 cm × 3.0 cm in size, and exhibited a clear-cut boundary from non-painful surrounding. A brain CT scan showed normal brain and right maxillary sinus polyp with bilateral chronic maxillary sinusitis. An assessment of nummular headache to rule out trigeminal neuralgia was made. Capsules Tramadol and Neurobion were added to his previous medications of amiptryptilline and Pregabalin and there was a good clinical response. This patient fulfils most of the International Headache Society diagnostic criteria (ICHD-3 beta) for NH and is currently stable on his medications.