Headache and liver disease: is their relationship more apparent than real?

Headache is regarded by patients as a disturbing (or unpleasant) symptom. It can be produced by either organic diseases or functional head abnormalities. Twenty-five years ago headache was supposed to be a psychosomatic angiospastic algia. Certain unusual forms were thought to be caused by triggers like anger, cough, exertion, and sexual activity. Experimental research explored the role of circulating serotonin, prostaglandin, estrogen levels, and platelet abnormalities. As computed tomography, helical computed tomography, and scanning or magnetic resonance imaging evolved, new data became available. None of the newer reports have demonstrated liver involvement as a cause of headache. This minireview intends to cover the spectrum of brain alteration in liver disease. It describes some of the pathophysiological characteristics of hepatic encephalopathy and, also, the relationship among migraine, constipation, and liver disease.