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Postoperative hemicrania continua-like headache - a case series
Andreas R Gantenbein1, Hakan Sarikaya, Franz Riederer
1Neurorehabilitation, RehaClinic Bad Zurzach, Bad Zurzach, Switzerland, a.gantenbein@rehaclinic.ch.
Insights
Hemicrania continua (HC) can develop after brain surgery. This rare headache disorder, characterized by one-sided head pain and autonomic symptoms, responded to indomethacin treatment in three post-surgical patients.
Area of Science:
- Neurology
- Headache Medicine
Background:
- Hemicrania continua (HC) is a rare, chronic headache disorder.
- It is characterized by continuous unilateral head pain, cranial autonomic symptoms, and responsiveness to indomethacin.
- The underlying pathophysiology of HC remains largely unknown.
Observation:
- Three patients developed hemicrania continua following cranial surgery.
- These cases presented with a consistent phenotype of hemicranial headache.
- Two out of three patients also experienced exacerbations of cranial autonomic symptoms.
Findings:
- Post-craniotomy onset of hemicrania continua is reported in three cases.
- All patients exhibited continuous hemicranial headaches.
- Cranial autonomic symptoms and indomethacin responsiveness were observed.
Implications:
- The findings suggest that cranial surgery may trigger or activate hemicrania continua.
- This supports the hypothesis that primary headache disorders can be initiated by surgical insults.
- Further research into the neurobiological mechanisms linking craniotomy to HC is warranted.
Background:
Hemicrania continua (HC) is a rare chronic headache disorder, typically accompanied by cranial autonomic features and responding to therapeutic doses of indomethacin. The pathophysiology of hemicrania continua is not fully understood.
Findings:
We report a series of three patients who developed a continuous hemicranial headache after cranial surgery. Each case presented a similar phenotype of continuous half-sided headache, cranial autonomic symptoms with exacerbations (2/3), and a response to indomethacin.
Conclusion:
The biology of hemicrania continua may be activated post-craniotomy just as can be seen with other primary headache disorders.
