Cluster Headache-Like Headaches: A Symptomatic Feature?: A Report of Three Patients with Intracranial Pathologic Findings

Greve, E; Mai, Jesper

doi:10.1046/j.1468-2982.1988.0802079.x

Cited by 58 publications

(27 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There are case reports of symptomatic cluster headache with lesions in the same general anatomical area as in our case 1, in which the existence of the tumor could have been responsible for the symptoms by stimulating the autonomic nervous system pathways and pain-sensitive structures, such as the cavernous sinus and carotid artery. 4,[7][8][9] For the second patient, we speculate that a subclinical periodontal infection was responsible for stimulation of the trigeminovascular system which, according to Moskowitz, plays the principal role in the pathophysiology of headaches. 10 The remission period for this patient has been 22 months.…”

Section: Commentsmentioning

confidence: 99%

Two More Secondary Headaches Mimicking Chronic Paroxysmal Hemicrania. Is This the Exception or the Rule?

et al. 1996

View full text Add to dashboard Cite

Two patients with headaches meeting the criteria of chronic paroxysmal hemicrania, as defined by the International Headache Society classification, are presented. Further investigations revealed parasellar pituitary microadenoma in the first patient and a maxillary cyst in the second. Surgical removal of the lesions resulted in complete relief from headaches. The clinical features of this rare syndrome are discussed and suggest that a more detailed laboratory study and clinical follow-up is necessary in patients with chronic paroxysmal hemicrania.Key words: chronic paroxysmal hemicrania, secondary headache, headache diagnosis Abbreviations: CPH chronic paroxysmal hemicrania (Headache 1996;36:511-513) Chronic paroxysmal hemicrania (CPH) is a rare disorder which resembles cluster headache and is characterized by short attacks, lasting from 2 to 45 minutes. It is associated with autonomic nervous system changes and responds to treatment with indomethacin (150 mg/day or less). 1 It is considered a variant form of cluster headache but with differences in duration and frequency of attacks, sex distribution, and therapeutic response to indomethacin. 2,3 Recently, a number of reports have described the coexistence of CPH and intracranial lesions or vascular disorders. [3][4][5] Two patients with CPH are presented. Laboratory examination revealed a tumor in the right parasellar area of the first patient, and physical examination of the second patient revealed a maxillary cyst. CASE HISTORIESPatient 1.-A 20-year-old man, with no family history of headache, was seen for the first time in our department in March 1994. His symptoms had started 1 year previously and consisted of attacks of severe throbbing and pulsating pain located in the right supraorbital area. The headache, lasting 10 to 20 minutes occurred 5 to 10 times a day; pain was associated with lacrimation, nasal congestion, rhinorrhea, ptosis, and severe unilateral eyelid edema. Many of the attacks occurred during sleep. At times, ptosis and eyelid edema persisted between attacks. Physical and neurological examinations did not reveal any abnormalities. A brain CT scan taken at this time was normal. Cluster headache was diagnosed and treatment with carbamazepine (400 mg daily) and amitriptyline (25 mg daily) produced a significant decrease both in frequency and intensity of the attacks. Six months later, however, the attacks occurred with greater intensity and higher frequency, and the patient was totally incapacitated. At this time, he was admitted to our department. Physical and neurological examinations yielded normal results, except for right eyelid edema. Routine hematology and biochemical screening were normal. Indomethacin (75 mg per day) was prescribed, and the intensity and frequency of attacks markedly decreased. Nevertheless, a repeat brain CT scan demonstrated a right parasellar hypodense area; coronal MRI with intravenous Gd-DPTA showed a signal intensity slightly less than that of the normal pituitary gland. On the basis of these findings, the dia...

show abstract

Section: Commentsmentioning

confidence: 99%

Two More Secondary Headaches Mimicking Chronic Paroxysmal Hemicrania. Is This the Exception or the Rule?

et al. 1996

View full text Add to dashboard Cite

show abstract

“…Observations of pituitary adenomas, parasellar meningiomas or neurinomas support the hypothesis that pain and autonomic symptoms in CH originate within the cavernous sinus region [3,7,10]. For some authors, one of the clues for a causal relationship between the two diseases lies in the relief of CLH symptoms without recurrence after treatment of the lesion [13,14,26]. Among arguments to explain such a relationship, Hannertz clearly demonstrated by orbital phlebography that venous drainage in the cavernous sinus was impaired by the tumor.…”

Section: Clh and Pathologies Of The Cavernous Sinus And Its Vicinitymentioning

confidence: 94%

“…Thus, CLH only includes cases that fully adhere to the IHS description of CH differing only by the presence of another disease which may be involved. Greve and Mai [13] or Porta-Etessam et al [14] described such observations in which the occurrence of another neurological disease eliminates the diagnosis of CH even if all the symptoms adhere to IHS criteria. In these cases, several questions remain unanswered.…”

Section: Definitionmentioning

confidence: 99%

“…In fact, in most cases, duration of pain is actually more prolonged than in CH and autonomic signs are frequently lacking [25]. Nevertheless, Tfelt-Hensen et al [26], Greve and Mai [13] and Porta-Etassam et al [14] described several, well-documented cases. In these observations, pituitary prolactinomas or growth-hormone producing adenomas were always macroadenomas with suprasellar and laterosellar infiltrations.…”

Section: Clh and Pathologies Of The Cavernous Sinus And Its Vicinitymentioning

confidence: 99%

“…Vertebral or carotid artery aneurysms are associated in rare cases with CLH [13,36] although the temporal link between the two diseases is not clear. In West and Todman's case [36], CLH did not fulfill IHS criteria.…”

Section: Clh and Cranial Vesselsmentioning

confidence: 99%

See 2 more Smart Citations

Cluster-like headache: literature review

et al. 2002

View full text Add to dashboard Cite

Trigeminal Autonomic Cephalgias Due to Structural Lesions

Favier

Vliet²,

Roon³

et al. 2007

Arch Neurol

140

View full text Add to dashboard Cite

rigeminal autonomic cephalgias (TACs) include cluster headache, paroxysmal hemicrania, and short-lasting unilateral neuralgiform headache with conjunctival injection and tearing. Associated structural lesions may be found, but a causal relationship is often difficult to establish. We sought to identify clinical predictors of underlying structural abnormalities by reviewing previously described and new TAC and TAC-like cases associated with a structural lesion. We found that even typical TACs can be caused by an underlying lesion. Clinical warning signs and symptoms are relatively rare. We recommend neuroimaging in all patients with a TAC or TAC-like syndrome.

show abstract

Cluster Headache-Like Headaches: A Symptomatic Feature?: A Report of Three Patients with Intracranial Pathologic Findings

Cited by 58 publications

References 14 publications

Two More Secondary Headaches Mimicking Chronic Paroxysmal Hemicrania. Is This the Exception or the Rule?

Two More Secondary Headaches Mimicking Chronic Paroxysmal Hemicrania. Is This the Exception or the Rule?

Cluster-like headache: literature review

Trigeminal Autonomic Cephalgias Due to Structural Lesions

Contact Info

Product

Resources

About