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Cluster headache and intracranial aneurysm

Abstract

In the present study we describe the cases of two patients with cluster-like headache related to intracranial carotid artery aneurysm. One of these patients responded to verapamil prescription with headache resolution. In both cases the surgical clipping of the aneurysm resolved the cluster pain. These findings strongly suggest a pathophysiological link between the two conditions. The authors discuss the potential pathophysiological mechanisms underlying cluster-like headache due to intracranial carotid artery aneurysm.

References

  1. 1.

    May A, Goadsby PJ (2001) Hypothalamic involvement and activation in cluster headache. Curr Pain Headache Rep 5:60–66, 10.1007/s11916-001-0011-4, 1:STN:280:DC%2BD3M3os1GrtA%3D%3D, 11252139

    Article  CAS  PubMed  Google Scholar 

  2. 2.

    Todo T, Inoya H (1991) Sudden appearance of a mycotic aneurysm of the intracavernous carotid artery after symptoms resembling cluster headache: case report. Neurosurgery 29:594–598; discussion 598–599, 10.1097/00006123-199110000-00019, 1:STN:280:DyaK38%2FltVWnug%3D%3D, 1944843

    Article  CAS  PubMed  Google Scholar 

  3. 3.

    Valença MM, da Silva WF, Andrade-Valença LPA et al (2007) Cluster headache attacks in a woman previously struck by lightning — Pathophysiology of the latent period. Arq Neuropsiquiatr 65:352–354, 17607444

    Article  PubMed  Google Scholar 

  4. 4.

    Formisano R, Angelini A, De Vuono G et al (1990) Cluster-like headache and head injury: case report. Ital J Neurol Sci 11:303–305, 10.1007/BF02333864, 1:STN:280:DyaK3czlsVaisw%3D%3D, 2387704

    Article  CAS  PubMed  Google Scholar 

  5. 5.

    Cremer PD, Halmagyi GM, Goadsby PJ (1995) Secondary cluster headache responsive to sumatriptan. J Neurol Neurosurg Psychiatry 59:633–634, 10.1136/jnnp.59.6.633, 1:STN:280:DyaK287gtlWgtw%3D%3D, 7500105

    PubMed Central  Article  CAS  PubMed  Google Scholar 

  6. 6.

    Zanchin G, Rossi P, Licandro AM et al (1995) Clusterlike headache. A case of sphenoidal aspergilloma. Headache 35:494–497, 10.1111/j.1526-4610.1995.hed3508494.x, 1:STN:280:DyaK28%2FhvFGgtA%3D%3D, 7591746

    Article  CAS  PubMed  Google Scholar 

  7. 7.

    Tajti J, Sas K, Szok D, Voros E, Vecsei L (1996) Clusterlike headache as a first sign of brain metastases of lung cancer. Headache 36:259–260, 10.1046/j.1526-4610.1996.3604259.x, 1:STN:280:DyaK283ltVyisg%3D%3D, 8675434

    Article  CAS  PubMed  Google Scholar 

  8. 8.

    Seijo Martinez M, Castro del Rio M, Cervigon E, Conde C (2000) [Symptomatic cluster headache: presentation of 2 cases] Neurologia 15:406–410, 1:STN:280:DC%2BD3M%2FpsV2nsQ%3D%3D, 11195150

    CAS  PubMed  Google Scholar 

  9. 9.

    Sarlani E, Schwartz AH, Greenspan JD, Grace EG (2003) Facial pain as first manifestation of lung cancer: a case of lung cancer-related cluster headache and a review of the literature. J Orofac Pain 17:262–267, 14558496

    PubMed  Google Scholar 

  10. 10.

    Soros P, Frese A, Husstedt IW, Evers S (2001) Cluster headache after dental extraction: implication for the pathogenesis of cluster headache? Cephalalgia 21:619–622, 10.1046/j.1468-2982.2001.00191.x, 1:STN:280:DC%2BD3MvisFSrtQ%3D%3D, 11472390

    Article  CAS  PubMed  Google Scholar 

  11. 11.

    Munoz C, Diez-Tejedor E, Frank A, Barreiro P (1996) Cluster headache syndrome associated with middle cerebral artery arteriovenous malformation. Cephalalgia 16:202–205, 10.1046/j.1468-2982.1996.1603202.x, 1:STN:280:DyaK28zhslSntw%3D%3D, 8734773

    Article  CAS  PubMed  Google Scholar 

  12. 12.

    Bigal ME, Rapoport AM, Camel M (2003) Cluster headache as a manifestation of intracranial inflammatory myofibroblastic tumour: a case report with pathophysiological considerations. Cephalalgia 23:124–128, 10.1046/j.1468-2982.2003.00508.x, 1:STN:280:DC%2BD3s7ktVGisw%3D%3D, 12603369

    Article  CAS  PubMed  Google Scholar 

  13. 13.

    Piovesan EJ, Lange MC, Werneck LC et al (2001) Cluster-like headache. A case secondary to the subclavian steal phenomenon. Cephalalgia 21:850–851, 10.1046/j.1468-2982.2001.218263.x, 1:STN:280:DC%2BD3MnovFKjsQ%3D%3D, 11737012

    Article  CAS  PubMed  Google Scholar 

  14. 14.

    Manzoni GC, Terzano MG, Bono G et al (1983) Cluster headache—clinical findings in 180 patients. Cephalalgia 3:21–30, 10.1046/j.1468-2982.1983.0301021.x, 1:STN:280:DyaL3s3gslSjtg%3D%3D, 6850818

    Article  CAS  PubMed  Google Scholar 

  15. 15.

    Milos P, Havelius U, Hindfelt B (1996) Clusterlike headache in a patient with a pituitary adenoma. With a review of the literature. Headache 36:184–188, 10.1046/j.1526-4610.1996.3603184.x, 1:STN:280:DyaK2s7gsVyhtg%3D%3D, 8984093

    Article  CAS  PubMed  Google Scholar 

  16. 16.

    Havelius U, Heuck M, Milos P, Hindfelt B (1996) Ciliospinal reflex response in cluster headache. Headache 36:568–573, 10.1046/j.1526-4610.1996.3609568.x, 1:STN:280:DyaK2s%2FnsVSiug%3D%3D, 8916567

    Article  CAS  PubMed  Google Scholar 

  17. 17.

    Kudrow L (1994) The pathogenesis of cluster headache. Curr Opin Neurol 7:278–282, 10.1097/00019052-199406000-00017, 1:STN:280:DyaK2czmt12hug%3D%3D, 8081523

    Article  CAS  PubMed  Google Scholar 

  18. 18.

    Sandrini G, Antonaci F, Lanfranchi S et al (2000) Asymmetrical reduction of the nociceptive flexion reflex threshold in cluster headache. Cephalalgia 20:647–652, 10.1046/j.1468-2982.2000.00096.x, 1:STN:280:DC%2BD3M7gsVOmuw%3D%3D, 11128822

    Article  CAS  PubMed  Google Scholar 

  19. 19.

    Moskowitz MA (1988) Cluster headache: evidence for a pathophysiologic focus in the superior pericarotid cavernous sinus plexus. Headache 28:584–586, 10.1111/j.1526-4610.1988.hed2809584.x, 1:STN:280:DyaL1M3lsVCmsQ%3D%3D, 3074069

    Article  CAS  PubMed  Google Scholar 

  20. 20.

    Kunkle EC (1982) Clues in the tempos of cluster headache. Headache 22:158–161

    Article  CAS  PubMed  Google Scholar 

  21. 21.

    Martins C, Yasuda A, Campero A, Rhoton AL Jr. (2006) Microsurgical anatomy of the oculomotor cistern. Neurosurgery 58(4 Suppl 2):ONS-220-227; discussion ONS-227-228, 10.1111/j.1526-4610.1982.hed2204158.x, 1:STN:280:DyaL383msVOktA%3D%3D, 7107242

  22. 22.

    Yasuda A, Campero A, Martins C et al (2005) Microsurgical anatomy and approaches to the cavernous sinus. Neurosurgery 56(1 Suppl):4–27; discussion 4–27, 10.1227/01.NEU.0000144208.42171.02, 15799789

    PubMed  Google Scholar 

  23. 23.

    Dimopoulos VG, Fountas KN, Feltes CH et al (2005) Literature review regarding the methodology of assessing third nerve paresis associated with non-ruptured posterior communicating artery aneurysms. Neurosurg Rev 28:256–260. Epub 2005 Jun 10, 10.1007/s10143-005-0393-6, 15947958

    Article  PubMed  Google Scholar 

  24. 24.

    Langer DJ, Zager EL, Flamm ES (1998) Parasurgical management of aneurismal subarachnoid hemorrhage. In: Cruz J (ed) Neurologic and Neurosurgical Emergencies, W. B. Saunders Company, Philadelphia, pp 205–241

    Google Scholar 

  25. 25.

    Lanzino G, Andreoli A, Tognetti F et al (1993) Orbital pain and unruptured carotid-posterior communicating artery aneurysms: the role of sensory fibers of the third cranial nerve. Acta Neurochir (Wien) 120:7–11, 10.1007/BF02001462, 1:STN:280:DyaK3s7ms12jtA%3D%3D

    Article  CAS  Google Scholar 

  26. 26.

    Berardinelli P, Scapolo PA, Barazzoni AM et al (2000) Nerve fiber composition of the intracranial portion of the oculomotor, trochlear, and abducens nerves in the sheep. Anat Rec 260:294–298, 10.1002/1097-0185(20001101)260:3<294::AID-AR66>3.0.CO;2-C, 1:STN:280:DC%2BD3M%2FjsFektQ%3D%3D, 11066039

    Article  CAS  PubMed  Google Scholar 

  27. 27.

    Bortolami R, Calza L, Lucchi ML et al (1991) Peripheral territory and neuropeptides of the trigeminal ganglion neurons centrally projecting through the oculomotor nerve demonstrated by fluorescent retrograde double-labeling combined with immunocytochemistry. Brain Res 547:82–88, 10.1016/0006-8993(91)90577-I, 1:STN:280:DyaK3Mzhs1KgsQ%3D%3D, 1713531

    Article  CAS  PubMed  Google Scholar 

  28. 28.

    Valença MM, Andrade-Valença LPA, Morais AA et al (2006) Na cefaléia em salvas secundária o lado esquerdo é o mais acometido e há um intervalo latente entre a injúria precipitante inicial e a dor. Arq Neuropsiquiatr 64(supp 1):11 [Portuguese]

    Google Scholar 

  29. 29.

    Havelius U (2001) A Horner-like syndrome and cluster headache. What comes first? Acta Ophthalmol Scand 79:374–375, 10.1034/j.1600-0420.2001.079004374.x, 1:STN:280:DC%2BD3Mvgt1KqsQ%3D%3D, 11453857

    Article  CAS  PubMed  Google Scholar 

  30. 30.

    Leone M, Curone M, Mea E, Bussone G (2004) Cluster-tic syndrome resolved by removal of pituitary adenoma: the first case. Cephalalgia 24:1088–1089, 10.1111/j.1468-2982.2004.00793.x, 1:STN:280:DC%2BD2crptlamsg%3D%3D, 15566423

    Article  CAS  PubMed  Google Scholar 

  31. 31.

    Triggle DJ (2006) L-type calcium channels. Curr Pharm Des 12:443–457, 10.2174/138161206775474503, 1:CAS:528:DC%2BD28XhsVKhtbg%3D, 16472138

    Article  CAS  PubMed  Google Scholar 

  32. 32.

    Toornvliet R, van Berckel BN, Luurtsema G et al (2006) Effect of age on functional P-glycoprotein in the blood-brain barrier measured by use of (R)-[(11)C]verapamil and positron emission tomography. Clin Pharmacol Ther 79:540–548, 10.1016/j.clpt.2006.02.004, 1:CAS:528:DC%2BD28Xltl2msrg%3D, 16765142

    Article  CAS  PubMed  Google Scholar 

  33. 33.

    Iannetti P, Spalice A, Parisi P (2005) Calcium-channel blocker verapamil administration in prolonged and refractory status epilepticus. Epilepsia 46:967–969, 10.1111/j.1528-1167.2005.59204.x, 15946342

    Article  PubMed  Google Scholar 

  34. 34.

    Horvat A, Momic T, Petrovic S et al (2006) Selective inhibition of brain Na,K-ATPase by drugs. Physiol Res 55:325–38. Epub 2005 Aug 5, 1:CAS:528:DC%2BD28XnsVWitL4%3D, 16083303

    CAS  PubMed  Google Scholar 

  35. 35.

    Favier I, van Vliet JA, Roon KI et al (2007) Trigeminal autonomic cephalgias due to structural lesions: a review of 31 cases. Arch Neurol 64:25–31, 10.1001/archneur.64.1.25, 17210806

    Article  PubMed  Google Scholar 

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Correspondence to Marcelo Moraes Valença.

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Valença, M.M., Andrade-Valença, L.P.A., Martins, C. et al. Cluster headache and intracranial aneurysm. J Headache Pain 8, 277–282 (2007). https://doi.org/10.1007/s10194-007-0412-9

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Keywords

  • Cerebral aneurysm
  • Cluster headache
  • Parasympathetic
  • Third cranial nerve
  • Internal carotid artery
  • Pathophysiology