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Recurrent activity-induced headache associated with posttraumatic dural adhesion of the middle meningeal artery: A
Lee Elisevich1, Justin Singer2, Meggen Walsh3
1Central Michigan University, Mount Pleasant, Michigan, USA.
Background:
The middle meningeal artery is surrounded by a plexus of afferent fibers shown to be involved in the progression of some forms of headache, especially migraine. Posttraumatic headache disorders sharing characteristics with migraine and involving the middle meningeal artery are not readily available in the literature.
Case Description:
This report describes a posttraumatic headache disorder in a middle-aged woman in which the causative factor proved to be a pathology of the left middle meningeal artery that resulted from trauma. Her pain could be triggered by moderate accelerative changes, occurring in the left frontotemporal region, and shared characteristics with migraine. Resection of a portion of the left middle meningeal artery has completely eliminated her pain syndrome.
Conclusion:
This case further elucidates associations between the middle meningeal artery and headache. The presentation of posttraumatic headache sharing characteristics with migraine should suggest the possibility of a middle meningeal artery abnormality.
Insights
A rare case of posttraumatic headache, similar to migraine, was linked to middle meningeal artery pathology. Surgical removal of the affected artery segment completely resolved the patient's debilitating headaches.
Area of Science:
- Neurology
- Vascular Surgery
- Pain Medicine
Background:
- The middle meningeal artery (MMA) is associated with headache disorders, particularly migraine, via its afferent nerve fibers.
- Posttraumatic headaches (PTH) with migraine-like features and MMA involvement are infrequently documented.
Observation:
- A middle-aged woman presented with PTH following trauma, characterized by left frontotemporal pain triggered by accelerative changes.
- Her symptoms closely resembled migraine, with the underlying cause identified as pathology of the left MMA.
Findings:
- Surgical resection of the affected portion of the left MMA successfully eradicated the patient's headache syndrome.
- This case highlights a direct link between MMA pathology and PTH with migraine features.
Implications:
- Abnormalities of the middle meningeal artery should be considered in cases of posttraumatic headache presenting with migraine-like characteristics.
- This finding may open new avenues for diagnosing and treating specific headache disorders involving the MMA.
