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Symptomatic cluster headache: a review of 63 cases
1Department of Clinical Sciences Lund, Faculty of Medicine, Neurology, Skane University Hospital, S-221 85, Lund, Sweden.
Springerplus
|February 27, 2014
Summary
Secondary causes of cluster headache (CH) are often overlooked. Neuroimaging is recommended for patients with atypical CH symptoms, late onset, or those resistant to treatment to rule out underlying structural lesions.
Area of Science:
- Neurology
- Headache Medicine
Background:
- Cluster headache is typically a primary headache disorder.
- Symptomatic cases linked to structural lesions are challenging to diagnose.
- Guidelines for neuroimaging in cluster headache are lacking.
Purpose of the Study:
- To review literature for symptomatic cluster headache (CH) cases with likely causality.
- To identify clinical predictors of underlying lesions in CH.
- To propose guidelines for neuroimaging in CH.
Main Methods:
- Literature review of symptomatic cluster headache or cluster headache-like cases.
- Analysis of 63 identified cases associated with underlying lesions.
- Assessment of clinical presentation and examination findings.
Main Results:
- A majority of reviewed cases presented atypically (symptoms, examination findings).
- Pituitary gland diseases and arterial dissection were notable secondary causes.
- Typical cluster headaches can also be secondary to structural lesions.
Conclusions:
- Neuroimaging, particularly contrast-enhanced MRI/MRA, is advised for atypical CH presentations, late onset, abnormal exams (including Horner's syndrome), or treatment resistance.
- The decision for neuroimaging in typical CH remains a clinical judgment.
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