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Cardiac cephalalgia: one case with cortical hypoperfusion in headaches and literature review

Miao Wang1, Lu Wang2, Changfu Liu3

  • 1The Department of Geriatric Neurology, Chinese PLA General Hospital, Beijing, China.

The Journal of Headache and Pain
|February 22, 2017
PubMed

Insights

Cardiac cephalalgia (CC) is a rare condition linked to heart ischemia. A new case reveals cerebral hypoperfusion during CC headaches, suggesting a vessel constriction mechanism.

Area of Science:

  • Cardiology
  • Neurology
  • Medical Research

Background:

  • Cardiac cephalalgia (CC) is a rare condition associated with myocardial ischemia, often relieved by nitroglycerin.
  • Despite over 30 reported cases since 1997, the underlying mechanism of CC remains unclear.
  • This study presents a novel case and literature review to explore CC pathophysiology.

Observation:

  • A patient with CC exhibited cortical hypoperfusion during headache episodes, a previously unreported finding.
  • Review of 35 CC cases (1997-2016) identified common clinical, neuroimaging, ECG, and coronary angiography features.

Findings:

  • The presented CC case demonstrated cerebral hypoperfusion during headache attacks.
  • Literature review synthesized clinical and diagnostic features of 35 CC patients.
  • A novel vessel constriction hypothesis for CC pathophysiology was proposed based on observed hypoperfusion.

Implications:

  • The findings suggest a potential vascular mechanism involving vessel constriction in cardiac cephalalgia.
  • This research may lead to a better understanding and diagnosis of this rare condition.
  • Further investigation into the proposed mechanisms could inform future therapeutic strategies for CC.
Abstract

Keywords:
Cardiac cephalalgiaClinical featuresNeuroimagesPathophysiology

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