Abstract
Background: Hemicrania continua is a primary headache disorder characterized by a continuous, unilateral headache associated with ipsilateral cranial autonomic features that responds to indomethacin. By definition, the symptoms are not referable to an underlying structural pathology. However, several cases of secondary hemicrania continua related to underlying structural lesions have been reported. Case: We present a case of a 53-year-old male with a prolonged, right-sided headache associated with intermittent right-sided ptosis, conjunctival injection, tearing, and nasal congestion, suggestive of hemicrania continua, who was found to have an indirect carotid-cavernous fistula, and who, after endovascular treatment of the fistula, had resolution of his symptoms. Conclusion: Alternative, and perhaps less common, causes of headache should be considered when the clinical presentation is atypical or does not clearly fulfill diagnostic criteria for primary headache disorders. Carotid cavernous fistulas should be included within this differential, and represent a potentially treatable and reversible cause of otherwise refractory headache.
| Original language | English (US) |
|---|---|
| Journal | Headache |
| DOIs | |
| State | Published - Jan 1 2019 |
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Keywords
- carotid cavernous fistula
- headache
- hemicrania continua
ASJC Scopus subject areas
- Neurology
- Clinical Neurology
Cite this
Carotid Cavernous Fistula Mimicking Hemicrania Continua : A Case Report. / Arnold Fiebelkorn, Catherine; Lanzino, Giuseppe; Chen, John; Brinjikji, Waleed; Eckel, Laurence J.; Boes, Christopher J.
In: Headache, 01.01.2019.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Carotid Cavernous Fistula Mimicking Hemicrania Continua
T2 - A Case Report
AU - Arnold Fiebelkorn, Catherine
AU - Lanzino, Giuseppe
AU - Chen, John
AU - Brinjikji, Waleed
AU - Eckel, Laurence J.
AU - Boes, Christopher J.
PY - 2019/1/1
Y1 - 2019/1/1
N2 - Background: Hemicrania continua is a primary headache disorder characterized by a continuous, unilateral headache associated with ipsilateral cranial autonomic features that responds to indomethacin. By definition, the symptoms are not referable to an underlying structural pathology. However, several cases of secondary hemicrania continua related to underlying structural lesions have been reported. Case: We present a case of a 53-year-old male with a prolonged, right-sided headache associated with intermittent right-sided ptosis, conjunctival injection, tearing, and nasal congestion, suggestive of hemicrania continua, who was found to have an indirect carotid-cavernous fistula, and who, after endovascular treatment of the fistula, had resolution of his symptoms. Conclusion: Alternative, and perhaps less common, causes of headache should be considered when the clinical presentation is atypical or does not clearly fulfill diagnostic criteria for primary headache disorders. Carotid cavernous fistulas should be included within this differential, and represent a potentially treatable and reversible cause of otherwise refractory headache.
AB - Background: Hemicrania continua is a primary headache disorder characterized by a continuous, unilateral headache associated with ipsilateral cranial autonomic features that responds to indomethacin. By definition, the symptoms are not referable to an underlying structural pathology. However, several cases of secondary hemicrania continua related to underlying structural lesions have been reported. Case: We present a case of a 53-year-old male with a prolonged, right-sided headache associated with intermittent right-sided ptosis, conjunctival injection, tearing, and nasal congestion, suggestive of hemicrania continua, who was found to have an indirect carotid-cavernous fistula, and who, after endovascular treatment of the fistula, had resolution of his symptoms. Conclusion: Alternative, and perhaps less common, causes of headache should be considered when the clinical presentation is atypical or does not clearly fulfill diagnostic criteria for primary headache disorders. Carotid cavernous fistulas should be included within this differential, and represent a potentially treatable and reversible cause of otherwise refractory headache.
KW - carotid cavernous fistula
KW - headache
KW - hemicrania continua
UR - http://www.scopus.com/inward/record.url?scp=85067411532&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85067411532&partnerID=8YFLogxK
U2 - 10.1111/head.13566
DO - 10.1111/head.13566
M3 - Article
JO - Headache
JF - Headache
SN - 0017-8748
ER -