Nummular Headache Secondary to An Intracranial Mass Lesion

Abstract

Nummular headache is a coin-shaped, chronic cephalalgia usually considered to stem from epicranial tissues. We describe a patient complaining of circumscribed pain in the head as the only symptom of a subtentorial meningioma. This observation underlines the need to revise the concept of circumscribed, referred pains in the head arising from pain-sensitive intracranial structures.

A high prevalence of autoimmune indices and disorders in primary nummular headache

“…We think that there are three important reasons for underestimation, including a paucisymptomatology of autoimmune disorder at initial presentation, an incomplete survey of autoimmune indices in overall patients, and a shortage of detailed follow-up study after an initial diagnosis of NH. Nevertheless, the findings in our patients urge us to examine the primary theory of NH when autoimmune disorders are prevalent in our series and intracranial secondaries [6][7][8] have also been found in a few NH patients.…”

“…NH is proposed a form of peripheral neuralgia of the trigeminal nerve [3] which is supported by the consistency of pain pattern, focal atrophic change [4], and local sensory alteration [5] within the painful area. Although intracranial secondaries [6][7][8] and previous focal trauma [9] have been found in a few NH patients, the etiopathogenesis of NH is factually unknown. Since autoimmune disorders frequently involve the trigeminosensory nerve to produce a variety of craniofacial pain, they may therefore also provoke NH.…”

Nummular headache and pituitary lesion: A case report and literature review

“…In contrast to a putative suggestion of peripheral neuralgia in NH, a few intracranial disorders, such as meningioma[8] or arachnoidal cyst,[9] have been found in patients presenting with a typical course of NH. The causal relation is further encouraged when pain subsides after a removal of meningioma in a patient.…”

Trigeminal Neuralgia Evolving Into Nummular Headache

“…Since the initial paper describing NH, 4 many case series and reports have been published that have speculated on the possible etiology and pathophysiology of NH. There has been evidence presented favoring both peripheral and central etiologies, as well as descriptions of primary 4 and secondary 5 NH. Currently, it appears the majority of evidence supports a peripheral cause.…”