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Superficial artery aneurysms underlying nummular headache--2 cases and proposed diagnostic work-up
Pedro López-Ruiz1, María-Luz Cuadrado, Angel Aledo-Serrano
1Department of Neurology, Hospital Clínico San Carlos, Universidad Complutense, Madrid, Spain.
Introduction:
Nummular headache, considered a primary headache in the 3rd edition of the International Classification of Headache Disorders, has nonetheless been attributed in several occasions to underlying epicranial anomalies.
Case Reports:
Vascular imaging of the head in 2 patients with nummular headache revealed fusiform aneurysms of the scalp vessel in close relation to the painful area. One of the patients underwent surgical resection of the aneurysm with excellent response. A response to triptans was noted in both.
Discussion:
In selected patients with nummular headache, vascular imaging of the scalp may reveal anomalies amenable to surgical treatment or triptan administration, sometimes resulting in disappearance of the pain.
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