Assessment of inflammation with hematological parameters in patients with migraine and tension-type headache: a prospective study from a tertiary care center

Aim: To investigate the role of inflammatory markers in patients with an acute headache attack. Materials & methods: This prospective controlled observational study comprised 150 subjects (migraine with aura [MA] n = 51, migraine without aura [MO] n = 51, tension-type headache n = 48, healthy controls n = 80). White blood cells (WBCs), neutrophil, lymphocyte and platelet counts, mean platelet volume, neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio were documented. Results: MA and MO constituted 14.2% of the admissions to the emergency department due to headaches. In addition, MA and MO had higher WBC and MO showed higher neutrophil count during the attacks than healthy control (p < 0.05). Conclusion: Although inflammatory parameters, including WBC and neutrophil counts, were high in headache patients, neutrophil-to-lymphocyte ratio did not show a significant rise. Clinical trial registration: NCT04891848.Lay abstract Headache is one of the most common symptoms in patients admitted to emergency departments (ED). The vast majority of cases present with acute headache attacks in ED have a diagnosis of primary headache disorders, including tension-type headache (TTH) and migraine. Both of these headache types may contribute to a disabling process that decreases productivity and quality of life. Migraine is a chronic neurological disorder characterized by recurrent one-sided headache attacks with throbbing pain, lasting 4–72 h, accompanied by nausea and vomiting and sensitivity to light and/or sound. This disease usually manifests in the third–fourth decades of life, with female predominance. TTH is the most frequent type of primary headache disorder, characterized by mild to moderate pain with a ‘pressing’ or ‘tightening’ feeling lasting from 30 min to 7 days. Nausea or vomiting and sensitivity to light or sound are not seen with TTH. A relationship has been shown between these headache types and the number of cells in the blood, including red blood cells, white blood cells and platelets. In this study, we investigated the association of the number of blood cells in patients admitted to the ED with headache attacks and then compared the results of these patients with a healthy group of participants.