Two Cases of Primary Stabbing Headache

Abstract

Primary stabbing headache is an excruciating and relatively rare type of headache that typically lasts for only a few seconds. Pain is predominantly felt in the distribution of the first division of the trigeminal nerve and can be experienced as single stabs or as a series of stabs, either per day or every few days. Primary stabbing headache has been well-defined for decades and must be kept in mind during diagnosis. Exclusion of other possible causes is necessary in order to establish diagnosis. Indomethacin has classically been considered the first treatment option, but therapeutic failure occurs in up to 35% of cases. Recent studies have suggested that cyclooxygenase-2 inhibitors, gabapentin, nifedipine, paracetamol, and melatonin are also effective treatments.

Premature Ventricular Complex Causing Ice-Pick Headache

“…Although there is not an exact mechanism in the pathophysiology of IPH, irritation of the trigeminal or other nerves has been suggested as a possible mechanism [1]. This situation can explain the stabbing headache in the temporal region of the head and accompanying strike of lighting in our patient.…”

“…IPH is the shortest lasting headache known and it usually occurs without other symptoms. There is not a linkage between IPH and other neurological disorders [1, 2]. Among the various types of headache, migraine is known to be associated with cardiac diseases and cardiac anomalies [6].…”

“…Ice-pick headache (IPH), which is also named as “primary stabbing headache” was first defined by Lansche as “ophthalmodynia periodica.” The exact prevalence is unknown but %2–30 of the adult population is thought to be affected in their lifetime [1]. It is characterized with stabbing, momentary headache attacks lasting seconds, being repetitive and transient, and manifestation of multiple jolts.…”

“…It has a female dominance. The main pathophysiological mechanism underlying this type of headache is unknown [1, 2]. …”