Postmeningitis headache

Acute meningitis is associated with headache, but the natural history of the headache following recovery is unknown. We addressed this issue in 141 patients admitted during 1990 to 1993 with laboratory-confirmed meningitis. We excluded patients younger than 5 years (n=44), elderly demented patients (n=6), and those with potential causes of headache other than meningitis (n=4). Seventeen candidates could not be traced. The remaining 70 patients were interviewed using a semistructured questionnaire that documented age, sex, type of meningitis, time of headache onset after infection, and headache description as well as any past and/or family history of headache. These patients 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 meningitis in 19 patients (33%; migrainous in 6), increasing the total prevalence to 46%. We found no association between sex, type of meningitis, or family history and the development of postmeningitis headache. Patients who developed postmeningitis headache were significantly younger than those who did not. We conclude that there is an association between meningitis, either bacterial or aseptic, and subsequent persistent recurrent migrainous or nonmigrainous headache.