Generalized headache, or cephalagia, may be a symptom of many different diseases and is of doubtful diagnostic significance unless associated with other symptoms of intracranial changes. Localized headache, however, is frequently of diagnostic significance and may indicate the region of intracranial involvement, as illustrated by the case here to be reported.
Intracranial operations under regional anesthesia have demonstrated that the brain is insensitive to pain and that the dura mater is probably the only sensitive tissue encountered; the greatest discomfort is caused by ligation or manipulation of the meningeal vessels.
According to Teachenor,1 the dura has a rich and somewhat complicated nerve supply. It is supplied mainly from the fifth and tenth cranial nerves and the sympathetic system, although some fibers are derived from the fourth and twelfth cranial nerves. A branch of the mandibular division of the fifth nerve, which is given off directly after the exit of
Craig WM. LOCALIZED HEADACHE ASSOCIATED WITH LESION OF MENINGEAL VESSELS. JAMA. 1933;100(11):816-817. doi:10.1001/jama.1933.27420110003010b