Publicação
Cluster Headache Secondary to Trauma Presenting with Unilateral Mydriasis
| Resumo: | Cluster headache is the most common trigeminal autonomic cephalalgia, it can be a primary or secondary headache. Attacks are frequently associated with autonomic symptoms, due to parasympathetic activation and sympathetic defect. An 86-year-old woman, with no previous history of headache, developed a right supraorbital headache, two weeks after a fall, that resulted in mild head trauma to the ipsilateral frontal region. She complained of intense, daily attacks, with a circadian rhythm, lasting approximately 50-60 minutes, without psychomotor agitation. During the episodes, she noted right monocular blurred vision, and occasionally perceived colored shapes. During the attacks, right eye mydriasis was seen, without other autonomic signs. The diagnosis of cluster headache was admitted and started symptomatic treatment with oxygen and prophylaxis with verapamil, with unequivocal improvement. We pretend to highlight this complex and poorly understood relation between trauma and cluster headache, as well as emphasize the atypical autonomic manifestations of this entity. |
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| Autores principais: | Gonçalo Pinheiro, Rita |
| Outros Autores: | Peres, João; Tojal, Raquel; Parreira, Elsa |
| Assunto: | Cluster Headache/etiology Craniocerebral Trauma/ complications Mydriasis Cefaleia em Salvas/etiologia Midríase Traumatismos Craniocerebrais/ complicações |
| Ano: | 2024 |
| País: | Portugal |
| Tipo de documento: | artigo |
| Tipo de acesso: | unknown |
| Instituição associada: | Sociedade Portuguesa de Neurologia |
| Idioma: | inglês |
| Origem: | SINAPSE |
| Resumo: | Cluster headache is the most common trigeminal autonomic cephalalgia, it can be a primary or secondary headache. Attacks are frequently associated with autonomic symptoms, due to parasympathetic activation and sympathetic defect. An 86-year-old woman, with no previous history of headache, developed a right supraorbital headache, two weeks after a fall, that resulted in mild head trauma to the ipsilateral frontal region. She complained of intense, daily attacks, with a circadian rhythm, lasting approximately 50-60 minutes, without psychomotor agitation. During the episodes, she noted right monocular blurred vision, and occasionally perceived colored shapes. During the attacks, right eye mydriasis was seen, without other autonomic signs. The diagnosis of cluster headache was admitted and started symptomatic treatment with oxygen and prophylaxis with verapamil, with unequivocal improvement. We pretend to highlight this complex and poorly understood relation between trauma and cluster headache, as well as emphasize the atypical autonomic manifestations of this entity. |
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