Acoustic neuroma presenting as a hypnic headache

Area of Science:

• Neurology
• Neurosurgery

Background:

• Hypnic headache (HH) is a rare primary headache disorder exclusively occurring during sleep.
• Acoustic neuroma (AN) is a benign tumor of the vestibulocochlear nerve, typically presenting with auditory or balance issues.

Observation:

• A 40-year-old woman presented with nocturnal headaches consistent with HH.
• She also had a history of bilateral tinnitus and was diagnosed with a large left-sided acoustic neuroma.

Findings:

• The patient's HH-like syndrome resolved after gamma knife radiosurgery for the acoustic neuroma.
• This is the first reported case of acoustic neuroma presenting as a hypnic headache-like syndrome.

Implications:

• Acoustic neuroma should be considered in the differential diagnosis of secondary hypnic headache.
• Neuroimaging is essential for identifying structural intracranial causes of headache syndromes mimicking primary disorders.