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February 1983

Mechanisms of Headache With Angina

Author Affiliations

Department of Neurology Bowman Gray School of Medicine Winston-Salem, NC 27103
Department of Neurology Loyola University Medical Center Maywood, IL 60153

Arch Neurol. 1983;40(2):127. doi:10.1001/archneur.1983.04050020089026

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To the Editor.  —We appreciate Daniels' comments (Archives 1982;39:602-603) regarding the mechanism of headache in the patient described in our case report, "Bregmatic Headache as a Manifestation of Myocardial Ischemia" (Archives 1982;39:130). Increased venous pressure and distention of pain-sensitive intracranial structures may well explain the occurrence of headache in some patients with angina. In our patient, however, headache was the initial manifestation of each attack, preceded chest pain by several seconds, and was unaccompanied by change in respiration or shortness of breath. We recommend neither costly workup for these patients nor adoption of new rubrics, but merely seek to call attention to an interesting clinical observation.

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