Can the cold also cause headaches?

This is the 4753th article of Da Yi Xiao Hu

The Great Cold is the coldest solar term of the year. It snowed again in the north today after the Great Cold. My classmate Xiaofang called me and asked why I had such frequent headaches when it was the coldest. After asking in detail, I learned that she went to Harbin Ice and Snow World, danced in the evening, watched ice lanterns, and ate three Madiel ice creams while walking on Central Avenue. When she returned to the hotel, she started to have a severe headache. She tossed for several hours and took painkillers to fall asleep. Xiaofang's painful experience may have been experienced by your friends. Can cold also cause headaches? Today we will talk about cold stimulation headaches.

1. What is cold stimulation headache?

As the name suggests, cold stimulation headache is a headache caused by external cold stimulation of the head or the ingestion or inhalation of cold stimulation. In the latest version of the International Headache Classification Guide, it is divided into three types: headache due to external cold stimulation, headache due to the ingestion or inhalation of cold stimulation, and probable cold stimulation headache. Let's take a closer look at what each type of headache is:

1. Headache due to external cold stimulation

A generalized headache that occurs after an unprotected head is exposed to extremely low temperatures is called an "external cold headache." This type of headache is triggered by an external cold stimulus, such as exposure to cold weather, immersion in cold water, or cryotherapy. Some patients experience severe, short-term stabbing pain in the middle of the forehead, but may also present with unilateral temporal, frontal, or retroorbital pain.

2. Headache attributed to ingestion or inhalation of cold stimuli

Headache due to ingestion or inhalation of cold stimuli was once called "ice cream headache" or "brain freeze headache", which means "the head is frozen and throbbing" in Northeastern dialect. This headache is usually short-lived and can be severe. It is caused by cold substances (solid, liquid or gas) passing through the palate and/or posterior pharyngeal wall of susceptible people. It is particularly likely to be triggered by eating shaved ice quickly, but eating ice cream, even if eaten slowly, can easily trigger it. It is also very common in the general population, especially in patients with migraine. The headache is prone to occur in the frontal or temporal areas and usually occurs bilaterally, but it can also be unilateral.

3. Probable cold stimulus headache

When the headache caused by exposure to cold environment or ingestion of cold stimuli only meets one of the two typical headache characteristics mentioned above, we call it "probable cold stimulus headache".

How is it? After seeing these characteristics, if you are a headache patient, do you have a little fear of winter? Don't be afraid, is it a cold stimulation headache? Let's get straight to the point and see what the diagnostic criteria are:

Diagnosis of cold stimulus headache

1. Diagnostic criteria for headache attributed to external cold stimulation

A. At least 2 acute headache attacks meeting criteria B and C

B. Caused by external cold stimulation of the head and only occurs when there is cold stimulation

C. Headache relief within 30 minutes after removal of cold stimulus

D. Not better explained by another ICHD-3 diagnosis

Note: ICHD-3: International Classification of Headaches, Third Edition

2. Diagnostic criteria for headache attributed to ingestion or inhalation of cold stimuli

A. At least 2 episodes of acute frontal or temporal headache meeting criteria B and C

B. Immediately after consuming cold food, beverages, or inhaling cold air, the palate and/or posterior pharyngeal wall are exposed to cold

C. The headache disappears within 10 minutes after the cold stimulus is removed

D. Not better explained by another ICHD-3 diagnosis.

3. Probable cold stimulus headache diagnostic criteria

A. A single episode that meets criteria B and C

B. Only occurs immediately after the head is exposed to cold external stimuli or after eating or inhaling cold stimuli

C. The headache disappears within 10 minutes after the cold stimulus is removed

D. Does not meet the diagnostic criteria for any other type of headache in ICHD-3

E. Not better explained by another ICHD-3 diagnosis.

Compare carefully, do you have all these items?

3. How to treat it?

Similar to the acute treatment of migraine, analgesics such as nonsteroidal anti-inflammatory drugs can be given when headaches occur. The drugs we are all familiar with are ibuprofen, diclofenac sodium, aspirin, acetaminophen, painkillers, etc. Of course, there are also star drugs among specific analgesics - triptan drugs, sumatriptan, zolmitriptan, rizatriptan, etc. can all be used.

Of course, the most important thing for cold stimulation headaches is to avoid the triggers, eat less cold drinks, go out as little as possible in the winter or in cold environments, or keep warm when going out, such as wearing the recently popular Northeastern style large flowered jacket, which has a good effect of cold protection and warmth. If you can also wear a "dog skin hat" of the Oroqen people or a "roe deer head hat" of the Ewenki people, you will not only be the most handsome guy on the streets of Harbin, the hottest ice city in the north, but also avoid headaches and suffer less in cold weather!

Author: Jilin University Second Hospital

Department of NeurologyMan YuhongChief Physician