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Chronic Unilateral Headache Related to Scar Neuromas.
Karen S Ferreira1, Jose G Speciali2
1Department of Neurology, Suroit Hospital, Salaberry-de-Valleyfield, QC, Canada.
Journal of Medical Cases
|July 12, 2023
Summary
Headaches after surgery or trauma may stem from scar neuromas. Anesthetic blockade of these neuromas provided complete headache relief in two patients, suggesting a novel treatment approach for refractory unilateral headaches.
Area of Science:
- Neurology
- Pain Medicine
Background:
- Postcraniotomy and posttraumatic headaches can manifest as neuropathic pain.
- Scar neuromas are hypothesized to cause and maintain this type of chronic headache.
Observation:
- Two patients presented with chronic unilateral headaches ipsilateral to their scars (posttraumatic and postsurgical).
- Standard pharmacological treatments for primary headaches, such as trigeminal autonomic cephalalgia (TAC), were ineffective.
Findings:
- Anesthetic blockade of scar neuromas resulted in complete remission of headaches in both patients.
- Clinical examination confirmed the presence of scar neuromas as the likely pain source.
Implications:
- Searching for traumatic or nontraumatic scars is crucial in patients with refractory unilateral headaches.
- Anesthetic blocks targeting scar neuromas offer a potentially effective treatment for these debilitating headaches.
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