Which disorders can present with headache and hypertension
Severe frontal or occipital pulsating or constant paroxysmal headaches may occur in 51% to 80% of those with pheochromocytoma, variably accompanied by sweating, palpitations, pallor, anxiety, tremor, visual disturbances, abdominal or chest pain, nausea, vomiting, facial flushing, and occasionally paresthesias. The headaches typically last less than 1 hour in 70% of patients.
Preeclampsia and eclampsia occur during pregnancy or up to 4 weeks postpartum with a blood pressure of >140/90 mm Hg on two readings at least 4 hours apart or a rise in diastolic pressure of ≥15 mm Hg or of systolic pressure of ≥30 mm Hg along with urinary protein excretion greater than 0.3 g/24 hours.
The usually bilateral and pulsating headache occurs in 63% of those with preeclampsia.
A severe throbbing headache can occur in 56% to 85% of those with a spinal cord injury (SCI) and autonomic dysreflexia.
The headache of SCI and autonomic dysreflexia is associated with a paroxysmal rise above baseline in systolic pressure of ≥30 mm Hg and/or diastolic pressure ≥20 mm Hg and can be triggered by either noxious or nonnoxious stimuli such as bladder distention, urinary tract infection, bowel distention or impaction, gastric ulcer, decubiti, trauma, or procedures.
The latency from onset after the SCI can range from 4 days to 15 years and is more common in those with a complete SCI.
