Investigation of the characteristics of headache due to unruptured intracranial vertebral artery dissection

Matsumoto, Hiroaki; Hanayama, Hiroaki; Sakurai, Yasuo; Minami, Hiroaki; Masuda, Akira; Tominaga, Shogo; Miyaji, Katsuya; Yamaura, Ikuya; Yoshida, Yasuhisa; Hirata, Yutaka

doi:10.1177/0333102418791818

Cited by 14 publications

(16 citation statements)

References 21 publications

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“…In both entities, a lesion of the ascending pathways of the trigeminal nuclei is mostly the cause, next to damage to the cervical spinothalamic pathways or cortical processing areas. Another cause of facial pain is cervical carotid or vertebral artery dissection [62]. The facial pain is usually ipsilateral to the side of the dissected vessel and mostly of sudden onset.…”

Section: Central Causes Of Facial Painmentioning

confidence: 99%

Facial Pain: A Comprehensive Review and Proposal for a Pragmatic Diagnostic Approach

et al. 2020

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Background: Facial pain, alone or combined with other symptoms, is a frequent complaint. Moreover, it is a symptom situated at, more than any other pain condition, a crosspoint where several disciplines meet, for example, dentists; manual therapists; ophthalmologists; psychologists; and ear-nose-throat, pain, and internal medicine physicians besides neurologists and neurosurgeons. Recently, a new version of the most widely used classification system among neurologists for headache and facial pain, the International Classification of Headache Disorders, has been published. Objective: The aims of this study were to provide an overview of the most prevalent etiologies of facial pain and to provide a generic framework for the neurologist on how to manage patients presenting with facial pain. Methods: An overview of the different etiologies of facial pain is provided from the viewpoint of the respective clinical specialties that are confronted with facial pain. Key message: Caregivers should "think outside their own box" and refer to other disciplines when indicated. If not, a correct diagnosis can be delayed and unnecessary treatments might be given. The presented framework is aimed at excluding life-or organthreatening diseases, providing several clinical clues and indications for technical investigations, and ultimately leading to the correct diagnosis and/or referral to other disciplines.

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Section: Central Causes Of Facial Painmentioning

confidence: 99%

Facial Pain: A Comprehensive Review and Proposal for a Pragmatic Diagnostic Approach

et al. 2020

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“…Our study Shibahara [12] Matsumoto [16] Acute pain 89. pain onset in the headache group, and on day 51 in the infarction group. All changes started before 3rd month and ended after 6 to 7 months when the image tracking period was limited to 1 year or less (Figs.…”

Section: Characteristics (%)mentioning

confidence: 76%

Acute hemicranial pain accompanied with a pearl and string type dissection of intracranial vertebral artery: Consideration for the time when to finish the medical observation

et al. 2022

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The International Classification of Headache Disorder (ICHD) clearly guides the suspicion of intracranial vertebral artery dissection (ICVAD) in headache patients, but guidelines on how observational or imaging studies should be performed to detect dangerous progression early are unclear. Fifty-six cases with pearl and string type intracranial vertebral artery dissection were divided into 3 groups: 39 in the headache group, 6 in the infarction group, and 11 in the hemorrhagic group. Clinical and angiographic data were analyzed and compared. Most headaches resolved within 2 weeks and did not exceed 8 weeks. Of the 33 patients (84.6%) who underwent continuous follow-up imaging, 18 (54.5%) returned to normal, but 3 (9%) had deteriorated. All the patients survived without subsequent bleeding or infarction. Image changes started before 3rd month and ended after 6 to 7 months. In acute ICVADs, image changes occur at the same time as the headache resolves and continue for several months after the headache has subsided. Since the dissection is likely to worsen even after the headache disappears, the image changes continue over several months, and prediction of rupture of unruptured ICVAD is unpredictable, it is desirable to conduct continuous imaging studies regularly after the initiation of dissection until stabilization is confirmed.

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“…Headache is the common symptom in patients with cervical artery dissection (CAD), but the characteristics of pain associated with CAD are not specific and can sometimes resemble migraine or even cluster headache (2). A recent study showed that more specific headache characteristics in patients with intracranial vertebral artery dissection included: headache in the occipitonuchal region, with unilateral, pulsatile and acute onset, with severe intensity, and without nausea or vomiting (8). .…”

Section: Resultsmentioning

confidence: 99%

Headache occurring during rehabilitation in a migrainous patient with cervical spinal cord injury

Stănescu¹,

Bulboacă²,

Ursu³

et al. 2019

Balneo

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Traumatic vertebral artery (VA) dissection is a severe consequence of a cervical injury, which usually involves the vertebrae and spinal cord. Traumatic VA dissection has been frequently underdiagnosed or misdiagnosed, mainly because many patients remain asymptomatic. The consequence of VA dissection is ischemia in the territory supplied by the affected artery. The VA dissection presents most often as a vertebrobasilary transient ischemic attack or ischemic stroke, usually preceded by local symptoms such as neck pain or headache. Headache is a common symptom in patients with cervical artery dissection, but its characters are not specific. Diagnosis of VA dissection usually requires a CT-angiography. Delayed onset of symptoms with a variable asymptomatic interval, ranging from several days to 3 months, has been reported. The risk of stroke remains high, especially in the first weeks after the confirmation of VA dissection. Treatment of traumatic VA dissections include anticoagulation or antiplatelet therapy and revascularization techniques. We present the case of a patient with spinal cord injury and operated C5 fracture, who was diagnosed with unilateral VA dissection 6 months after the traumatic event, during the rehabilitation program.

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Investigation of the characteristics of headache due to unruptured intracranial vertebral artery dissection

Cited by 14 publications

References 21 publications

Facial Pain: A Comprehensive Review and Proposal for a Pragmatic Diagnostic Approach

Facial Pain: A Comprehensive Review and Proposal for a Pragmatic Diagnostic Approach

Acute hemicranial pain accompanied with a pearl and string type dissection of intracranial vertebral artery: Consideration for the time when to finish the medical observation

Headache occurring during rehabilitation in a migrainous patient with cervical spinal cord injury

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