Ayurvedic management of Krimija shiroroga (~headache secondary to postinfectious granulomatous sequelae)

Krimija shiroroga (~headache secondary to postinfectious granulomatous sequelae) is a condition described in the classics of Ayurveda, linked to the diseases of the head caused by worm infestation. In contemporary science, this clinical presentation closely aligns with chronic headaches secondary to intracranial parasitic infections. Here, the case report of a 30-year-old woman with persistent, recurring headache for several months is being documented. The patient also reported heaviness in head along with itching, and occasional nasal discharge, often accompanied by fever, cough, nausea, loss of strength, and irritability. Despite undergoing modern medical treatment, the complaint of headache continued to re-occur and persisted. On assessment, Vata (~ Dosha responsible for movement and cognition) and Kapha dosha (~ Dosha responsible for regulating body fluids and keeping the body constituents cohesive) vitiation was identified as the primary pathological factor. The treatment protocol included Nasya karma (~medication through nasal route) for the elimination of vitiated Dosha from the Urdhvajatru (~part of body above the clavicle), along with the administration of Krimighna (~anti-helminthic) formulation. The patient was also advised dietary and lifestyle modification, including Yoga. After the completion of treatment, significant clinical improvement was observed with reduced pain intensity on Numeric Rating Scale from 9/10-2/10, suggesting 77.8% reduction. The frequency of headache decreased from four times daily to two times weekly, accounting for 80% reduction. Moreover, the functional disability improved from Grade IV (disabling) to Grade I (mild: able to perform daily activities/none: no disability), as assessed by the Migraine Disability Assessment (MIDAS) questionnaire. No recurrence was observed on a one-month follow-up. This case demonstrates the positive outcome of the structured Ayurveda management protocol in providing substantial symptomatic relief, along with functional and sustained recovery in a patient diagnosed with Krimija shiroroga.