From The City of London Migraine Clinic, UK.
Ponytail Headache: A Pure Extracranial Headache
Article first published online: 7 MAY 2004
Headache: The Journal of Head and Face Pain
Volume 44, Issue 5, pages 411–413, June 2004
How to Cite
Blau, J. N. (2004), Ponytail Headache: A Pure Extracranial Headache. Headache: The Journal of Head and Face Pain, 44: 411–413. doi: 10.1111/j.1526-4610.2004.04092.x
- Issue published online: 7 MAY 2004
- Article first published online: 7 MAY 2004
- Accepted for publication November 10, 2003.
Fifty of 93 females experienced headache from wearing a ponytail. Pain was experienced only at the site of the hair tie in 10 subjects, extending in others, forwards to the vertex (n = 5) or forehead (n = 7), laterally to the parietal region (n = 8) or temples (n = 3), downwards to the neck (n = 5), or to other areas (n = 12). Loosening the hair relieved pain immediately in 4 subjects, within half an hour in 32, and within an hour in 5 subjects; the remaining 9 subjects were uncertain of pain duration. This headache was preventable by wearing the ponytail more loosely tied.
Ponytail headache, well known to females, is not described in the medical literature because the remedy is obvious, therefore those affected do not seek medical advice. This seemingly common headache provides an example of a pure extracranial headache arising from pericranial muscle fascia and tendon traction. Males almost certainly have similar experiences, but were not questioned in this study.
Distinguishing intracranial from extracranial headache is essential in diagnosis and treatment. Further research on ponytail and other extracranial headaches could shed light on the mechanism of tension-type headache.