Cases reported "Cluster Headache"

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1/202. cluster headache-like attack as an opening symptom of a unilateral infarction of the cervical cord: persistent anaesthesia and dysaesthesia to cold stimuli.

    A 54 year old man experienced excruciating left retro-orbital pain with lacrimation and redness of the eye representative of a cluster headache attack. This was followed by left hemiparesis with plegia of the lower limb and left Horner's syndrome. Five days later the hemiparesis recovered while the patient developed hypoanaesthesia to cold stimuli that evoked painful burning dysaesthesia on the right side below the C4 level. MRI disclosed a discrete infarct in the left lateral aspect of the cord at C2 level concomitant to a left vertebral artery thrombosis. This limited infarct and the clinical symptoms suggest a hypoperfusion in the peripheral arterial system of the left hemicord, supplied both by the anterior and posterior spinal arteries. cluster headache-like attack and persistent dysaesthesia to cold stimuli are discussed respectively in view of the central sympathetic involvement and partial spinothalamic system dysfunction. ( info)

2/202. Hemicrania continua: ocular discomfort heralding painful attacks.

    It is known that in a minority of patients attacks of hemicrania continua may be accompanied by ipsilateral ocular discomfort. This symptom mostly occurs during exacerbations and is regularly concurrent with the pain. The observations reported here suggest that in hemicrania continua, ocular discomfort may, in rare cases, precede by a considerable length of time the onset of pain. It is postulated that the asynchronous appearance of these clinical features may reflect either an extreme fluctuation of the intensity of the pain or a dissociation of the pain from the ocular discomfort. ( info)

3/202. lithium and clonazepam treatment of two cases with cluster headache.

    patients with cluster headache are often treated with lithium. However, there are some patients who can not be fully treated with lithium alone. Two patients with cluster headache were treated with clonazepam, one of the most potent benzodiazepines. lithium prolonged the period of remission, and the addition of clonazepam further prolonged it in case 1. Treatment with clonazepam reduced the symptoms in case 2, and when combined with lithium, the disorder went into remission after 6 months. These findings suggest that the combination of lithium and clonazepam may be effective in patients with cluster headache. ( info)

4/202. Functional magnetic resonance imaging in spontaneous attacks of SUNCT: short-lasting neuralgiform headache with conjunctival injection and tearing.

    A 71-year-old woman presented with a short history of episodes of severe left-sided orbital and temporal pain in paroxysms lasting 60 to 90 seconds, and accompanied by ipsilateral lacrimation of the eye, rhinorrhea, and conjunctival injection. Results of clinical examination and structural imaging were normal and a clinical diagnosis of SUNCT (short-lasting unilateral neuralgiform pains with conjunctival injection and tearing) was made. The patient had a BOLD contrast-magnetic resonance imaging study in which significant activation was seen in the region of the ipsilateral hypothalamic gray, comparing the pain to pain-free state. The region of activation was the same in this patient as has been reported in acute attacks of cluster headache. ( info)

5/202. cluster headache-like disorder in childhood.

    This paper reviews the diagnostic features of cluster headache-like disorder and describes its presentation in childhood. Case note summaries of patients with this condition are presented in the context of a brief summary of the literature. Four patients (two girls; aged 12 to 15 years) with cluster headache-like disorder were seen over a period of four years in the paediatric neurology department of Birmingham Children's Hospital. Their histories and clinical courses are described. All had a history of "thrashing around" or bizarre behaviour during attacks, which had distracted attention from the headache and seemed to contribute to delay in diagnosis. It appears that cluster headache-like disorder does occur in childhood but is not common and can be mistaken for other conditions. A history of thrashing around accompanied by headache is very suggestive. Recognition of the symptoms in the general paediatric clinic would allow rapid diagnosis. ( info)

6/202. cluster headache-like pain in multiple sclerosis.

    We describe a case with simultaneous occurrence of cluster headache-like pain and multiple sclerosis. Both neuroimaging and neurophysiology (trigeminal evoked potentials) revealed a demyelination plaque in the pons, at the trigeminal root entry zone, on the side of pain. Although that type of lesion is usually associated with trigeminal neuralgia pain, we hypothesize that in this case it may be linked with the concomitant cluster headache, possibly by activation of trigemino-vascular mechanisms. ( info)

7/202. cluster headache with aura.

    cluster headache with aura is rare. The authors retrospectively reviewed 101 cluster headache patient charts at the Jefferson Headache Center. Six patients had an associated aura, five visual and one olfactory, lasting 5 to 120 minutes. Only one had migraine (without aura). Auras always occurred with or were followed by a severe cluster headache. Two patients were related. ( info)

8/202. Alteration in nature of cluster headache during subcutaneous administration of sumatriptan.

    OBJECTIVES: To document the relationship between the 5-HT receptor agonist sumatriptan and a change in the nature of cluster headache in four cases. To relate the findings to the literature on the use of sumatriptan in both cluster headache and migraine. BACKGROUND: Studies of the efficacy and adverse effects of long-term treatment with sumatriptan in cluster headache are limited and report conflicting findings. methods: Four cases are described. RESULTS: All four patients developed a marked increase in the frequency of attacks 3 to 4 weeks after initiating treatment with the drug for the first time. Three patients also developed a change in headache character, and 2 experienced prolongation of the cluster headache period. Withdrawal of the drug reduced the frequency of headaches and eliminated the newly developed type of headache. CONCLUSIONS: Determination of the effects of long-term use of sumatriptan will result in more precise guidelines for the frequency and duration of treatment with this otherwise extremely beneficial drug. ( info)

9/202. Simultaneous occurrence of ipsilateral cluster headache and chronic paroxysmal hemicrania: a case report.

    A 42-year-old man came to our headache unit in October 1995 complaining of recurrent attacks of headache, which had begun in February 1991. Chronic cluster headache was diagnosed, and he was given verapamil, 360 mg per day. The attacks ceased in the following months and verapamil was stopped in March 1996. In May 1997, a recurrence of the attacks required the readministration of verapamil, 360 mg per day. The attacks decreased (one to three per week), but after 2 months the patient reported a worsening in his condition due to the appearance of shorter attacks, which were diagnosed as chronic paroxysmal hemicrania. The administration of indomethacin, 225 mg per day, resulted in the disappearance of the short attacks. The concomitant occurrence of attacks of cluster headache and chronic paroxysmal hemicrania suggests the presence of shared factors in the pathophysiology of the two forms of headache. This hypothesis is supported by previous reports in the literature. ( info)

10/202. Cluster-tic syndrome: report of five new cases.

    The so-called short lasting primary headaches include heterogenic entities that can be divided between those without pronounced autonomic activation and those where this activation is evident, which includes the cluster-tic syndrome. We report five new cases with age closer to the trigeminal neuralgia's one, and concomitance of cluster headache and trigeminal neuralgia, which is less frequent in the literature. We also discuss briefly the pathophysiology of these clinical entities, suggesting that the trigeminus nerve is a common pathway of pain manifestation. ( info)
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