Posttraumatic dysautonomic cephalalgia. Clinical observations and treatment

Five patients developed posttraumatic vascular headaches associated with autonomic dysfunction. The precipitating injury affected the anterior triangle of the neck, presumably involving the region of the carotid artery sheath. Disturbance of sympathetic function, characterized by excessive sweating and pupillary dilation associated with headache, was noted. Appropriate pharmacologic studies revealed evidence of partial sympathetic devervation. While headache was resistant to ergotamine preparations, prompt relief was obtained with propranolol hydrochloride, and adrenergic beta-receptor blocking agent.