A case of chronic cluster-like headache in a patient with cerebrovascular disease

The case of a cerebrovascular patient is presented, who at the age of 70 developed unilateral headache, localized in the left orbital region with radiation to the temporo-parietal homolateral region; the attacks lasted 15 to 60 min, presented a chronic temporal pattern from their onset and were accompanied by homolateral lacrimation, conjunctival injection, nasal stuffiness and ptosis of the eyelid. The headache also presented a circadian timing with more frequent occurrence in the evening or early morning h. Verapamil therapy was effective. The possible relevance of cerebrovascular disease with respect to the late onset of the headache is discussed.