Hemicrania Continua Secondary to an Ipsilateral Brainstem Lesion

Abstract

We describe a 47-year-old woman with a 3-year history of a continuum mild-moderate right-side headache, with exacerbations, associated with stabbing volleys of pain on right orbit-temporal region (10/10) and right eye ptosis and lacrimation with conjunctival injection. The pain was completely abolished with indomethacin (100 mg per day). The diagnosis of hemicrania continua was made according to the International Headache Society (IHS) criteria. The headache presentation was precipitated by a stroke and a right-side brainstem lesion was present at magnetic resonance imaging. This case report shows anatomoclinical evidence of the involvement of brainstem structures on the pathophysiology of hemicrania continua.

Secondary hemicrania continua: Case reports and a literature review

“…To avoid this problem, we included all the cases with sufficient demographic and clinical data who were defined as having HC or HClike headache by the authors. We identified 27 cases presented by the authors as HC in association with other pathologies or events [2,[6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25]. One patient of HC (associated with pineal cyst) lacks a detailed demographical and clinical data [26].…”

“…However, other points of Trucco et al criteria may or may not be relevant where onset of HC pain was associated with an event. We observed 12 cases where the onset of pain was in a close temporal relation with an event [6][7][8][9][10][11][12][13].…”

Neuroendocrine dysfunction in fibromyalgia and migraine

“…In the case of hypothalamic injury or dysfunction, headache may be the result of such damage. Thus, the hypothalamus and the adjacent brainstem both represent a complex interconnected neural region responsible for the chronobiological and autonomic features and lateralization of some headache disorders [33]. A disruption in the normal function of the hypothalamus is implicated in the genesis of some prodromal symptoms and signs of migraine, such as mood changes, drowsiness, thirst, craving for food, and yawning.…”

Hemicrania Continua–Like Headache With Leprosy: Casual or Causal Association?

“…The pain exacerbation periods usually last anywhere from 20 minutes to a few days 4 . Exacerbations for even a few minutes are reported in many HC or HC‐like headache 4‐8 . Frequencies of exacerbations are also variable, 2‐3 times in a week to 10‐20 times in a day 4‐8 .…”

“…Exacerbations for even a few minutes are reported in many HC or HC‐like headache 4‐8 . Frequencies of exacerbations are also variable, 2‐3 times in a week to 10‐20 times in a day 4‐8 . Agitation and even suicide attempt may be noted during exacerbation period 4,9 .…”