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[Symptomatic cluster headache: presentation of 2 cases].
M Seijo Martínez1, M Castro del Río, E Cervigon
1Servicio de Neurología, Complexo Hospitalario de Pontevedra. mseijom@meditex.es
Neurologia (Barcelona, Spain)
|February 24, 2001
Summary
Cluster headache can be a symptom of underlying structural brain abnormalities. Early neuroimaging is crucial for diagnosing secondary cluster-like headaches, ensuring proper treatment and improved patient outcomes.
Area of Science:
- Neurology
- Neurosurgery
Background:
- Cluster headache is a primary headache disorder with distinct diagnostic criteria.
- However, 3-5% of cases are secondary to cranial structural abnormalities.
- Atypical features like lack of periodicity and persistent background pain suggest a secondary cause.
Observation:
- Two patients presented with symptomatic cluster-like headaches.
- One case involved a superficial temporal artery fistula, resolved by embolization.
- The second case featured a ventricular xanthoma, treated with surgical excision.
Findings:
- Both patients experienced progressive increase in pain frequency and lacked regular hourly recurrence.
- Resolution of the underlying structural abnormality led to cessation of headache attacks.
- The ventricular xanthoma case is a rare presentation, with no similar prior descriptions.
Implications:
- Suspected secondary cluster-like headaches warrant prompt neuroimaging.
- Identifying and treating structural abnormalities can effectively resolve these headaches.
- This highlights the importance of considering secondary causes in atypical cluster headache presentations.