Postmeningitis headache

Acute meningitis is associated with headache, but the natural history of th e headache following recovery is unknown. We addressed this issue in 141 pa tients admitted during 1990 to 1993 with laboratory-confirmed meningitis. W e excluded patients younger than 5 years (n=44), elderly demented patients (n=6), and those with potential causes of headache other than meningitis (n =3), Seventeen candidates could not be traced. The remaining 70 patients we re interviewed using a semistructured questionnaire that documented age, se x, type of meningitis, time of headache onset after infection, and headache description as well as any past and/or family history of headache. These p atients were compared to age- and sex-matched controls (n=70), Prior to meningitis, 13 patients (19%) had had headaches (migrainous in 8) as did 18 controls (26%; migrainous in 8), Headache first appeared after me ningitis in 19 patients (33%; migrainous in 6), increasing the total preval ence to 46%, We found no association between sex, type of meningitis, or fa mily history and the development of postmeningitis headache. Patients who d eveloped postmeningitis headache were significantly younger than those who did not, We conclude that there is an association between meningitis, eithe r bacterial or aseptic, and subsequent persistent recurrent migrainous or n onmigrainous headache.