Headache and Scalp Edema in Sickle Cell Disease

     Giovanna Pari and Hyman M Schipper

Abstract:   Background: Major neurological complications of sickle cell disease include cerebral infarction and intracranial hemorrhages. Methods: We describe the case of a 25-year-old man with sickle cell disease who developed a severe headache of acute onset, located at the vertex. There was associated pitting edema of the scalp. Results: Technetium and gallium bone imaging showed focal decreased uptake of the tracers, consistent with a recent fronto-parietal skull infarction. Management included intravenous hydration and analgesic medication. Conclusions: In addition to the more common intracranial vaso-occlusive complications, skull infarction should be considered as a cause of new-onset headache in patients with sickle cell disease, especially if scalp edema is present.

Can. J. Neurol. Sci. 1996; 23: 224-226