RESUMO
By definition, cluster headache (CH) is not caused by underlying structural pathology. However, patients with CH or CH-like syndromes and an associated structural lesion have been described. In many cases it is difficult to establish a causal relation between the headache syndrome and the lesion. We reviewed the literature for symptomatic CH or CH-like cases in which causality was very likely, and we found that even typical CH with a typical episodic time pattern and a response to typical CH treatment can be caused by underlying structural pathology such as a pituitary tumor. Based on this small retrospective series of case reports, it is impossible to give advice about neuroimaging. If neuroimaging is considered, MRI (not CT) is the investigation of choice.
Assuntos
Cefaleia Histamínica/diagnóstico , Imageamento por Ressonância Magnética , Analgésicos/uso terapêutico , Cefaleia Histamínica/terapia , Humanos , Imageamento por Ressonância Magnética/métodos , Estudos RetrospectivosRESUMO
Trigeminal autonomic cephalgias (TACs) include cluster headache, paroxysmal hemicrania, and short-lasting unilateral neuralgiform headache with conjunctival injection and tearing. Associated structural lesions may be found, but a causal relationship is often difficult to establish. We sought to identify clinical predictors of underlying structural abnormalities by reviewing previously described and new TAC and TAC-like cases associated with a structural lesion. We found that even typical TACs can be caused by an underlying lesion. Clinical warning signs and symptoms are relatively rare. We recommend neuroimaging in all patients with a TAC or TAC-like syndrome.
Assuntos
Lesões Encefálicas/complicações , Cefalalgias Autonômicas do Trigêmeo/etiologia , Cefalalgias Autonômicas do Trigêmeo/patologia , Adulto , Lesões Encefálicas/patologia , Diagnóstico por Imagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , PubMed/estatística & dados numéricos , Cefalalgias Autonômicas do Trigêmeo/classificação , Cefalalgias Autonômicas do Trigêmeo/epidemiologiaRESUMO
Cluster headache (CH) is a rare but severe headache disorder characterised by repeated unilateral head pain attacks accompanied by ipsilateral autonomic features. In episodic CH, there are periods of headache attacks with pain-free intervals of weeks, months or years in between. A minority of patients have the chronic form, without pain-free intervals between the headache attacks. Chronic CH can occur as primary or secondary chronic CH; the rarest form is episodic CH arising from chronic CH. In this article, we give a review of the chronic forms of CH and focus on demographics, clinical manifestations, social habits, predictive factors, head injury, genetics, neuroimaging and therapy. It is remarkable that little is known about risk factors that make CH chronic.
