Chiari Malformation Type I Presenting as Cluster-like Headache

Although different types of headache have been described in Chiari malformation type I, reports of cluster-like headaches are rare.

We report a 26-year-old man who presented with a two-week history of excruciating headache in the right temporal region after coughing, which was accompanied by autonomic features including right-sided nasal congestion and tearing from his right eye. Sensory deficits in the first branch of the right trigeminal nerve and along C3-5 dermatomes were noted, and brain magnetic resonance imaging was compatible with a diagnosis of Chiari malformation type I.

A diagnosis of secondary cluster headache was made due to a lack of typical periodicity, and the presence of anhidrosis and sensory abnormalities and cough headache.