Cluster Headache and Internal Carotid Artery Dissection: Two Cases and Review of the Literature

Rigamonti, Andrea; Iurlaro, S.; Reganati, Paolo; Zilioli, Angelo; Agostoni, Elio

doi:10.1111/j.1526-4610.2007.01034.x

Cited by 31 publications

(21 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…107,113,116: cases 1 and 2; 118-120, 123).Among considered CLH patients (n = 148), 74.1% of the sample were male and 25.9% female, the M : F ratio being 2.7:1 (100/38, since data on patient gender were missing in 13 cases). The age of symptom onset was 42.8 Ϯ 15.2 years, while the age of correct diagnosis was 47.0 Ϯ 13.4 years.…”

mentioning

confidence: 99%

Cluster-like headache. A comprehensive reappraisal

et al. 2009

View full text Add to dashboard Cite

Among the primary headaches, cluster headache (CH) presents very particular features allowing a relatively easy diagnosis based on criteria listed in Chapter 3 of the International Classification of Headache Disorders (ICHD-II). However, as in all primary headaches, possible underlying causal conditions must be excluded to rule out a secondary cluster-like headache (CLH). The observation of some cases with clinical features mimicking primary CH, but of secondary origin, led us to perform an extended review of CLH reports in the literature. We identified 156 CLH cases published from 1975 to 2008. The more frequent pathologies in association with CLH were the vascular ones (38.5%, n = 57), followed by tumours (25.7%, n = 38) and inflammatory infectious diseases (13.5%, n = 20). Eighty were excluded from further analysis, because of inadequate information. The remaining 76 were divided into two groups: those that satisfied the ICHD-II diagnostic criteria for CH, 'fulfilling' group (F), n = 38; and those with a symptomatology in disagreement with one or more ICHD-II criteria, 'not fulfilling' group (NF), n = 38. Among the aims of this study was the possible identification of clinical features leading to the suspicion of a symptomatic origin. In the differential diagnosis with CH, red flags resulted both for F and NF, older age at onset; for NF, abnormal neurological/general examination (73.6%), duration (34.2%), frequency (15.8%) and localization (10.5%) of the attacks. We stress the fact that, on first observation, 50% of CLH presented as F cases, perfectly mimicking CH. Therefore, the importance of accurate, clinical evaluation and of neuroimaging cannot be overestimated.

show abstract

mentioning

confidence: 99%

Cluster-like headache. A comprehensive reappraisal

et al. 2009

View full text Add to dashboard Cite

show abstract

“…In a recent review on secondary cluster headache, 11 out of 63 patients had a carotid/vertebral dissection [3]. A review in 2007 identified 6 patients with ICA dissection presenting with cluster-like features [10] and several more cases have been described [11,12,13,14,15]. In all these patients, headache attacks disappeared within 2 months.…”

Section: Discussionmentioning

confidence: 99%

Post-Operative Cluster Headache Following Carotid Endarterectomy

Dirkx

Koehler²

2017

Eur Neurol

View full text Add to dashboard Cite

Background: Secondary cluster headache following carotid endarterectomy (CEA) is a rare condition and may help us understand the pathophysiology of primary cluster headache. Summary: We describe 2 patients diagnosed with cluster headache, fulfilling the ICHD-IIIB criteria, following CEA. Neither of the patients had headache prior to surgery. They both responded to treatment with oxygen and verapamil. Recent medical literature does not describe any definite cases of cluster headache following CEA. Cluster-like headache has been reported in several studies in the 1990s. Recent studies in primary cluster headache patients show evidence for a central origin of cluster headache in which no peripheral drive seems necessary. Key Messages: Our findings may provide more insight into the pathophysiology and show how a peripheral cause may lead to cluster headache. We hypothesize a role of the trigemino-autonomic reflex. Damage to the carotid artery may activate this reflex and trigger cluster headache. Injury to the internal carotid artery may unleash attacks in patients who are predisposed to develop cluster headache. Further study on the subject is needed to resolve this issue.

show abstract

“…41 The signs and symptoms experienced by the patient in this case report are similar to those described in other examples in medical literature. 15,[42][43][44][45] Internal carotid artery dissection accounts for up to one fifth of ischemic strokes occurring in people under the age of 45 years. It typically occurs in adults at a mean age of 40 years and with a male:female ratio of 1.5.…”

Section: Internal Carotid Artery Dissection Discussionmentioning

confidence: 99%