Headache and scalp edema in sickle cell disease.

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 intracranail vaso-occlusive complications, skull infarction should be considered as a cause of newonset headache in patients with sickle cell disease, especially if scalp edema is present.