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Primary headaches and painful spontaneous cervical artery dissection

Abstract

The relation between primary headaches (PH) and pain related to spontaneous cervical artery dissection (SCAD) is still unclear, as well as the progress of PH after dissection. To investigate this relation, the characteristics of pain related to SCAD and changes in PH patterns after SCAD, we evaluated 54 consecutive patients. Thirty-five (65%) had previous PH. Painful SCAD occurred in 39 (72%). Frontal and parietal localizations were significantly associated with internal carotid artery dissection (p=0.013 and p=0.010, respectively), whereas occipital and nuchal pain, with vertebral artery dissection (p=0.047 and p<0.001, respectively). Previous PH did not influence the presence of pain at SCAD onset. Twenty-six (74%) patients with PH reported improvement in PH pattern after a mean follow-up of 32 months. These results suggest that mechanisms underlying PH do not modulate dissection-related pain. Disruption of perivascular afferents may be involved in improvement of PH patterns after SCAD.

References

  1. 1.

    Pezzini A, Granella F, Grassi M et al (2005) History of migraine and the risk of spontaneous cervical artery dissection. Cephalalgia 25:575–580, 10.1111/j.1468-2982.2005.00919.x, 1:STN:280:DC%2BD2MznsF2jtg%3D%3D, 16033382

  2. 2.

    Tzourio C, Benslamia L, Guillon B, Aidi S, Bertrand M, Berthet K (2002) Bousser MG. Migraine and the risk of cervical artery dissection: a case-control study. Neurology 59:435–437, 1:STN:280:DC%2BD38vitV2qtA%3D%3D, 12177380

  3. 3.

    D’Anglejan-Chatillon J, Ribeiro V, Mas JL, Youl BD, Bousser MG (1989) Migraine: a risk factor for dissection of cervical arteries. Headache 29:560–561, 10.1111/j.1526-4610.1989.hed2909560.x, 2583992

  4. 4.

    Biousse V, D’Anglejan-Chatillon J, Massiou H, Bousser MG (1994) Head pain in non-traumatic carotid artery dissection: a series of 65 patients. Cephalalgia 14:33–36, 10.1046/j.1468-2982.1994.1401033.x, 1:STN:280:DyaK2c3lvVKqug%3D%3D, 8200023

  5. 5.

    Silbert PL, Mokri B, Schievink WI (1995) Headache and neck pain in spontaneous internal carotid and vertebral artery dissections. Neurology 45:1517–1522, 1:STN:280:DyaK2MzntFyqsA%3D%3D, 7644051

  6. 6.

    Arnold M, Cumurciuc R, Stapf C, Favrole P, Berthet K, Bousser MG (2006) Pain as the only symptom of cervical artery dissection. J Neurol Neurosurg Psychiatry 77:1021–1024, 10.1136/jnnp.2006.094359, 1:STN:280:DC%2BD28vptVKrsg%3D%3D, 16820416

  7. 7.

    Fisher CM (1982) The headache and pain of spontaneous carotid dissection. Headache 22:60–65, 10.1111/j.1526-4610.1982.hed2202060.x, 1:STN:280:DyaL383htlWluw%3D%3D, 7085262

  8. 8.

    Sturzenegger M (1994) Headache and neck pain: the warning symptoms of vertebral artery dissection. Headache 34:187–193, 10.1111/j.1526-4610.1994.hed3404187.x, 1:STN:280:DyaK2c3osVSksw%3D%3D, 8014032

  9. 9.

    Leys D, Moulin T, Stojkovic T, Begey S, Chavot D (1995) Follow-up of patients with history of cervical artery dissection. Cerebrovasc Dis 5:43–49, 10.1159/000107817

  10. 10.

    Lucas C (2005) Migraine et dissections artérielles cervicales. Rev Neurol (Paris) 161:703–705, 1:STN:280:DC%2BD2MvntVGhug%3D%3D

  11. 11.

    Headache Classification Subcommittee of the International Headache Society (2004) The International Classification of Headache Disorders. Cephalalgia 24[Suppl 1]:9–160

  12. 12.

    Silberstein SD, Saper JR, Freitag FG. (2001) Migraine: diagnosis and treatment. In: Silberstein SD (ed). Wolff’s headache and other head pain. 7th ed. New York: Oxford University Pr. p. 121–237

  13. 13.

    Kumral E, Bogousslavsky J, Van Melle G, Regli F, Pierre P (1995) Headache at stroke onset: the Lausanne Stroke Registry. J Neurol Neurosurg Psychiatry 58:490–492, 10.1136/jnnp.58.4.490, 1:STN:280:DyaK2M3ls1yksQ%3D%3D, 7738564

  14. 14.

    Moskowitz MA (1990) Mechanisms in vascular headache. Neurol Clin 8:801–815, 1:STN:280:DyaK3M%2FotVOqsQ%3D%3D, 2175382

  15. 15.

    Tentschert S, Wimmer R, Greisenegger S, Lang W, Lalouschek W (2005) Headache at stroke onset in 2196 patients with ischemic stroke or transient ischemic attack. Stroke 36:e1–e3, 10.1161/01.STR.0000151360.03567.2b, 15604424

  16. 16.

    Linetsky E, Leker RR, Ben-Hur T (2001) Headache characteristics in patients after migrainous stroke. Neurology 57:130–132, 1:STN:280:DC%2BD3MzptFejuw%3D%3D, 11445642

  17. 17.

    Gentile S, Fontanella M, Giudice RL, Rainero I, Rubino E, Pinessi L (2006) Resolution of cluster headache after closure of an anterior communicating artery aneurysm: the role of pericarotid sympathetic fibres. Clin Neurol Neurosurg 108:195–198, 10.1016/j.clineuro.2004.12.007, 16412843

  18. 18.

    Rotondi AJ, Chelluri L, Sirio C et al (2002) Patients’ recollections of stressful experiences while receiving prolonged mechanical ventilation in an intensive care unit. Crit Care Med. 30:746–752, 10.1097/00003246-200204000-00004, 11940739

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Keywords

  • Artery dissection
  • Carotid
  • Vertebral artery
  • Primary headaches
  • Migraine
  • Stroke

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