Ice Pick Headache

Ice pick headache is a sharp stabbing pain that people describe as having an ice pick jabbed through their skull numerous times.  They can occur as a single jab or a series of jabs with pain free intervals.  Although these headaches occur in the distribution of the trigeminal nerve, no clear relation to trigeminal neuralgia has been found.  The pain is described as sharp and stabbing.  It can occur in different areas of the head.  The duration is brief and no trigger factors are noted.  Ice Pick headache is more common in females than males.  The neurological exam of the patient is normal and no physiologic or anatomic cause can usually be found.  MRI of the brain and angiography are useful to eliminate other causes of headache such as tumor or multiple sclerosis.  Fortunately, ice pick headache usually responds to indomethacin, a non-steroidal anti-inflammatory medication.  Ice pick headache can be confused with other types of headaches such as migraine, trigeminal neuralgia and hemicrania continua