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Secondary chronic cluster headache treated by posterior hypothalamic deep brain stimulation: first reported case
Giuseppe Messina1, Michele Rizzi, Roberto Cordella
1Fondazione IRCCS Istituto Nazionale Neurologico Carlo Besta, Italy. giusmex@gmail.com
Cephalalgia : an International Journal of Headache
|November 21, 2012
Summary
Deep brain stimulation (DBS) of the posterior hypothalamus (pHyp) effectively treated secondary chronic cluster headache (CCH) in a patient with a rare neoplasm. This approach offers a potential new avenue for managing complex CCH cases.
Area of Science:
- Neurosurgery
- Neurology
- Oncology
Background:
- Chronic cluster headache (CCH) is a debilitating neurological disorder.
- Secondary CCH can arise from underlying conditions like neoplasms.
- Deep brain stimulation (DBS) of the posterior hypothalamus (pHyp) is an established treatment for primary CCH.
Observation:
- A case study of a 27-year-old male with secondary CCH due to a right hemiface angiomyolipoma is presented.
- The patient developed drug-refractory, homolateral CCH.
- DBS of the right pHyp region was performed.
Findings:
- Following DBS, the patient experienced a significant reduction in headache frequency.
- An infection necessitated system removal, followed by re-implantation.
- Successful outcomes were observed at a 2-year follow-up post-re-implantation.
Implications:
- Posterior hypothalamus DBS is a feasible treatment for secondary drug-refractory CCH.
- This case highlights a potential therapeutic option for complex CCH syndromes.
- Further research is warranted to validate these findings in larger cohorts.
