What are the other Names for this Condition? (Also known as/Synonyms)

• Headache due to Autonomic Dysreflexia

What is Headache Attributed to Autonomic Dysreflexia? (Definition/Background Information)

• Headache Attributed to Autonomic Dysreflexia is a headache disorder that occurs secondary to autonomic dysreflexia, which usually develops after an injury to the spinal cord. Autonomic dysreflexia is a life-threatening emergency and is mostly observed when the spinal cord injury involves the T6 (thoracic) or higher levels of vertebrae
• The sudden-onset and severe-intensity headache is often of the throbbing/pounding type. It is generally accompanied by high blood pressure (paroxysmal hypertension), irregular heartbeats, and abnormal sweating. The headache may worsen or improve depending on the increase or decrease in blood pressure respectively
• Autonomic dysreflexia can be triggered by factors (occurring below the level of the spinal cord injury) such as:
  • Bladder or bowel reflexes
  • Urinary tract infection (UTI)
  • Distended bladder
  • Clogged Foley catheter
  • Urological procedures
  • Stomach ulcers

The criteria for diagnosis of Headache Attributed to Autonomic Dysreflexia as outlined by the International Headache Society (IHS) is given below:

• Presence of spinal cord injury and autonomic dysreflexia documented by a paroxysmal rise above baseline in systolic pressure of 30 mm Hg or more, and/or diastolic pressure of 20 mm Hg or more
• Headache of sudden onset, fulfilling the criterion below

Evidence of causation demonstrated by at least two of the following:

• Headache has developed in temporal relation to the rise in blood pressure
• Either or both of the following:
  • Headache has significantly worsened in parallel with increase in blood pressure
  • Headache has significantly improved or resolved in parallel with decrease in blood pressure
• Headache has at least two of the following four characteristics:
  • Severe intensity
  • Pounding or throbbing (pulsating) quality
  • Accompanied by diaphoresis cranial to the level of the spinal cord injury
  • Triggered by bladder or bowel reflexes

Not better accounted for by another ICHD-3 diagnosis.

(Source: International Headache Society Classification ICHD-3, London, United Kingdom)