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Hemicrania continua-like headache associated with internal carotid artery dissection may respond to indomethacin

Avi Ashkenazi1, Muhammad A Abbas, Dinesh K Sharma

  • 1Department of Neurology, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA.

Headache
|March 16, 2007
PubMed

Insights

Hemicrania continua (HC) is a chronic headache disorder typically treated with indomethacin. A case revealed that cervical artery dissection can mimic HC symptoms, even responding initially to indomethacin.

Area of Science:

  • Neurology
  • Vascular Neurology

Background:

  • Hemicrania continua (HC) is defined as a continuous, strictly unilateral headache accompanied by ipsilateral cranial autonomic symptoms.
  • The disorder characteristically shows a significant response to indomethacin treatment.

Observation:

  • A patient presented with symptoms that closely mimicked HC.
  • This patient was diagnosed with traumatic internal carotid artery dissection.

Findings:

  • The patient's presentation initially responded to indomethacin, a hallmark treatment for HC.
  • This response created a diagnostic challenge, as the underlying cause was cervical artery dissection.

Implications:

  • Clinical presentations resembling HC warrant a high index of suspicion for underlying cervical arterial dissection.
  • Cervical artery dissection should be considered in the differential diagnosis of headaches with autonomic features, especially when they mimic HC.

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