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The Journal of Headache and Pain
Published in: The Journal of Headache and Pain 1/2013

Open Access 01-12-2013 | Case report

Carotid dissection mimicking a new attack of cluster headache

Authors: Elisa Candeloro, Isabella Canavero, Maurizia Maurelli, Anna Cavallini, Natascia Ghiotto, Paolo Vitali, Giuseppe Micieli

Published in: The Journal of Headache and Pain | Issue 1/2013

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Abstract

Background

Symptomatic cluster headache (CH) secondary to internal carotid artery dissection (ICAD) has been frequently reported, however, as far as we know, the coexistence of episodic CH and acute symptomatic CH secondary to ICAD has not.

Case report

A 39 year-old man, affected by episodic CH since the age of 19, presented an atypical headache associated with his usual autonomic symptoms. After a series of negative tests, MRA eventually revealed dissection of the right distal internal carotid artery.

Discussion and conclusions

The coexistence of episodic CH and acute CH symptomatic of ICAD in our patient suggests that, at least in some cases, CH and ICAD may be different expressions of a common underlying cause: hidden vessel wall damage. When risk factors and the change - though partial - of clinical features suggest symptomatic cases, CH patients have to be strictly monitored over time. Given the lack of a gold standard investigation for dynamic diseases such as dissections, these patients require multimodal diagnostic investigation over time, even in cases where exams are normal at onset.
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Metadata
Title
Carotid dissection mimicking a new attack of cluster headache
Authors
Elisa Candeloro
Isabella Canavero
Maurizia Maurelli
Anna Cavallini
Natascia Ghiotto
Paolo Vitali
Giuseppe Micieli
Publication date
01-12-2013
Publisher
Springer Milan
Published in
The Journal of Headache and Pain / Issue 1/2013
Print ISSN: 1129-2369
Electronic ISSN: 1129-2377
DOI
https://doi.org/10.1186/1129-2377-14-84

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