Paroxysmal Hemicrania as the Clinical Presentation of Giant Cell Arteritis

Abstract

Head pain is the most common complaint in patients with giant cell arteritis but the headache has no distinct diagnostic features. There have been no published reports of giant cell arteritis presenting as a trigeminal autonomic cephalalgia. We describe a patient who developed a new onset headache in her fifties, which fit the diagnostic criteria for paroxysmal hemicrania and was completely responsive to corticosteroids. Removal of the steroid therapy brought a reemergence of her headaches. Giant cell arteritis should be considered in the evaluation of secondary causes of paroxysmal hemicrania; in addition giant cell arteritis needs to be ruled out in patients who are over the age of 50 years with a new onset trigeminal autonomic cephalalgia.

Paroxysmal hemicrania associated to carotid artery dissection: a case report

“…6 There are descriptions of headache compatible with paroxysmal hemicrania associated with intracranial secondary lesions such as expansive lesions in the sella turcica, pituitary apoplexy, intraparenchymal pontomesencephalic hemorrhage, type I Chiari malformation and giant cell arteritis. 2,[7][8][9][10][11] ASAA Oliveira FAA, Rocha-Filho PAS Paroxysmal hemicrania associated to carotid artery dissection: a case report Our patient fulfilled the criteria for paroxysmal hemicranias, except for the frequency of pain, which was less than five attacks per day, on most days. We cannot completely rule out the possibility that the association between headache and dissection was a coincidence.…”

Symptomatic Trigeminal Autonomic Cephalalgias

“…We identified three cases of paroxysmal hemicrania, of whom all were excluded as they did not fulfil the ICHD-III criteria beta version [ 27 , 30 , 31 ]. The missing criterion in two patients was an unknown response to indomethacin [ 30 , 31 ], and the third reported bilateral instead of unilateral facial pain [ 27 ].…”