Trigeminal Autonomic Cephalalgia Secondary to Spontaneous Trigeminal Hemorrhage

Author(s):  
Mathieu Levesque ◽  
Christian Bocti ◽  
François Moreau
2012 ◽  
pp. 5-12
Author(s):  
Reinaldo Teixeira Ribeiro ◽  
André Leite Gonçalves ◽  
Maria Eduarda Nobre ◽  
Deusvenir de Souza Carvalho ◽  
Mario Fernando Prieto Peres

Cluster headache (CH) is the trigeminal autonomic cephalalgia whose pain is considered to be one of the most severe known to man. Although diagnosed less frequently than migraine and tension-type headaches, CH is nonetheless an important clinical entity, particularly given our evolving understanding of its actual epidemiology, pathophysiology, current diagnostic criteria and treatment approaches. We carried out a systematic review through the United States National Library of Medicine (PUBMED) by using the search term "cluster headache" and the results were narrowed to manuscripts published in the last ten years with subsequent reference searches and verification of source data. This article presents a review of the current understanding of the most important aspects of CH, with emphasis on mechanisms and treatment approaches.


Cephalalgia ◽  
2008 ◽  
Vol 28 (6) ◽  
pp. 605-608 ◽  
Author(s):  
M-S Yoon ◽  
M Obermann ◽  
G Fritsche ◽  
M Slomke ◽  
P Dommes ◽  
...  

We validated a German-language self-administered headache questionnaire for migraine (M), tension-type headache (TTH) and trigeminal autonomic cephalalgia (TAC) in a general population sample of people with headache. Randomly selected subjects ( n = 240) diagnosed by the questionnaire as M ( n = 60), TTH ( n = 60), a combination of M and TTH (M+TTH, n = 60) and TAC ( n = 60) were invited for examination by headache specialists. One hundred and ninety-three subjects (80%) were studied. Sensitivity and specificity for M were 0.85 and 0.85, for TTH 0.6 and 0.88, for M+TTH 0.82 and 0.87, respectively. Cohen's κ was 0.6 (95% confidence interval 0.50, 0.71). Of 45 patients with TAC according to the questionnaire, physicians diagnosed cluster headache in two patients only. We conclude: (i) the questionnaire can be used to diagnose M, TTH and M+TTH, but not TAC; (ii) screening questionnaires for epidemiological research should be validated in a general population sample but not in a tertiary headache clinic.


2018 ◽  
Vol 1 ◽  
pp. 251581631879054
Author(s):  
J Matthijs Biesbroek ◽  
Dirk R Rutgers ◽  
Sander van Gulik ◽  
Catherina JM Frijns

Short-lasting unilateral neuralgiform headache with autonomic symptoms (SUNA) is a rare form of trigeminal autonomic cephalalgia. SUNA is frequently associated with a trigeminal neurovascular conflict and rarely occurs secondary to other intracranial pathology. We report a patient with SUNA that was associated with ipsilateral meningeal inflammation caused by idiopathic hypertrophic pachymeningitis (HP). During the 9-year follow-up, she experienced multiple episodes of SUNA, most of which occurred during exacerbations of the pachymeningitis. This is the third case of SUNA associated with HP reported in the literature. Based on this observation, we suggest that in patients presenting with SUNA, besides dedicated magnetic resonance imaging (MRI) of the trigeminal nerve, gadolinium-enhanced brain MRI should be performed to rule out HP.


Cephalalgia ◽  
2020 ◽  
pp. 033310242095452
Author(s):  
Sharoon Qaiser ◽  
Andrew D Hershey ◽  
Joanne Kacperski

Introduction Trigeminal autonomic cephalalgias (TACs) are characterized by paroxysmal attacks of unilateral primary headaches associated with ipsilateral craniofacial autonomic symptoms. In this pediatric case series, 13 cases of short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT)/short-lasting unilateral neuralgiform headache with autonomic symptoms (SUNA), including children ages 3–18 years, are discussed. This paper reviews the application of International Classification of Headache Disorders, 3rd edition (ICHD-3) criteria especially in children presenting with SUNCT or SUNA. This is the largest pediatric case series of SUNCT/SUNA reported in the literature. Background Trigeminal autonomic cephalalgias are rare in children and adolescents, with SUNCT/SUNA having the least reported cases. We will discuss the application of ICHD-3 criteria to diagnose SUNCT/SUNA in children and review overlapping cases and their response to different treatment options including indomethacin, which is typically reserved for specific subtypes of TACs; for example, paroxysmal hemicrania. Conclusion This case series presents a unique opportunity to aid in the diagnosis and treatment of similar pediatric cases in the future. It helps us to broaden the ICHD-3 criteria to diagnose and treat different overlapping trigeminal autonomic cephalalgia cases in children.


2019 ◽  
Author(s):  
Patrick M. Chen ◽  
Sharona Ben-Haim ◽  
Jason Handwerker ◽  
Hossein Ansari

Abstract Objective: We present a rare case of Tic-cluster in the context of venous compression of the trigeminal nerve. Background: Cluster-Tic syndrome is a rare headache condition with features of both trigeminal neuralgia (Tic) and trigeminal autonomic cephalalgia symptom (TAC). Methods: Case report and review of literature. Results: A 75-year old man presents with left sided paroxysmal pain consistent with trigeminal neuralgia (Tic). Magnetic resonance demonstrated a venous compression of the posterior-medial aspect of the left trigeminal ganglion. He underwent microvascular decompression which confirmed petrosal vein compression with subsequent symptomatic resolution. After two years of remission, he had a new left unilateral throbbing headache consistent with International Classification of Headache Disorders (ICHD)- 3 cluster headache definition, which improved with steroids. Conclusion: Cluster-Tic syndrome has variable clinical presentations. Tic can precede cluster and the possible role of venous trigeminal compression in this headache remains unclear.


2019 ◽  
Vol 2 ◽  
pp. 251581631985707 ◽  
Author(s):  
Christian Ziegeler ◽  
Arne May

Paroxysmal hemicrania (PH) is a rare trigeminal autonomic cephalalgia (TAC) which is usually not associated with the menstrual cycle and usually affects the first trigeminal branch. We present a 47-year-old female patient with a facial variant of PH. For over 11 years, the patient had suffered from 8 to 12 typical PH attacks per day localized in the left maxilla in bouts of 4–9 days solely during her menstruation and ovulation. Single dosages of indomethacin 25 mg showed good efficacy in the prevention of the attacks for several hours. However, the intake of indomethacin had to be ceased due to severe psychiatric side effects. Ibuprofen 400 mg also reliably reduces the attack frequency with the same effectiveness as indomethacin. Attacks of PH can occur solely in the facial region and can be associated with the menstrual cycle which can prove to be a diagnostic challenge. Also, the intake of indomethacin can be limited by psychiatric side effects but can be adequately substituted by ibuprofen.


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