Related Experiment Video
Updated: Oct 25, 2025
3D-Neuronavigation In Vivo Through a Patient's Brain During a Spontaneous Migraine Headache
Published on: June 2, 2014
Secondary cluster headache due to a contralateral demyelinating periaqueductal gray matter lesion
Alessia Fiore1, Elena Tsantes1, Erica Curti1
1Neurosciences Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy.
Objectives/Background:
Tension-type headache and migraine without aura are the most common primary headaches occurring in people with demyelinating diseases, whereas cluster headache (CH) can be considered exceptional. The location of demyelinating lesions could be strategic in these cases, involving areas interacting with the trigeminovascular system.
Methods And Results:
We report a case of a 54-year-old woman with right-sided CH as the initial manifestation of multiple sclerosis and showing a left dorsal brainstem lesion on magnetic resonance imaging, in the region of the dorsal longitudinal fasciculus (DLF).
Conclusion:
Our case seems to suggest a possible role of the DLF in the process that leads to CH attacks. Because neuroimaging clearly showed a lesion contralateral to CH pain, we hypothesize that some fibers from periaqueductal gray matter project to the contralateral side, besides the known ipsilateral connections.
