Cluster Headache Secondary to Trauma Presenting with Unilateral Mydriasis

Authors

  • Rita Gonçalo Pinheiro Serviço de Neurologia, Hospital Professor Doutor Fernando Fonseca, Amadora, Portugal https://orcid.org/0000-0002-3295-0719
  • João Peres Serviço de Neurologia, Hospital Professor Doutor Fernando Fonseca, Amadora, Portugal
  • Raquel Tojal Serviço de Neurologia, Hospital Professor Doutor Fernando Fonseca, Amadora, Portugal
  • Elsa Parreira Serviço de Neurologia, Hospital Professor Doutor Fernando Fonseca, Amadora, Portugal

DOI:

https://doi.org/10.46531/sinapse/CC/220031/2022

Keywords:

Cluster Headache/etiology, Craniocerebral Trauma/ complications, Mydriasis

Abstract

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.

Downloads

Download data is not yet available.

References

Wei D, Khalil M, Goadsby P. Managing cluster headache. Pract Neurol.2019;19:521–8. doi: 10.1136/practneurol-2018-002124.

Burish M. Cluster headache: history, mechanisms, and most importantly treatment options. Pract Neurol. 2017: 34-6.

Gouveia R, Parreira E, Martins I. Autonomic features in cluster headache. Exploratory factor analysis. J Headache Pain. 2005;6:20-3. doi: 10.1007/s10194-005-0146-5.

de Coo IF, Wilbrink LA, Ie GD, Haan J, Ferrari MD. Aura in Cluster Headache: A Cross-Sectional Study. Headache. 2018;58:1203-10. doi: 10.1111/head.13344.

Carter DM. Cluster headache mimics. Curr Pain Headache Rep. 2004;8:133-9. doi: 10.1007/s11916-004-0027-7.

Turkewitz LJ, Wirth O, Dawson GA, Casaly JS. Cluster headache following head injury: a case report and review of the literature. Headache. 1992;32:504-6. doi: 10.1111/j.1526-4610.1992.hed3210504.x.

Manzoni GC, Lambru G, Torelli P. Head trauma and cluster headache. Curr Pain Headache Rep. 2006;10:130-6. doi: 10.1007/s11916-006-0024-0.

Fanciullacci M, Pietrini U, Gatto G, Boccuni M, Sicuteri F. Latent dysautonomic pupillary lateralization in cluster headache. A pupillometric study. Cephalalgia. 1982;2:135-44. doi: 10.1046/j.1468-2982.1982.0203135.x.

Drummond PD. Sweating and vascular responses in the face: normal regulation and dysfunction in migraine, cluster headache and harlequin syndrome. Clin Auton Res. 1994;4:273-85. doi: 10.1007/BF01827433. Erratum in: Clin Auton Res 1995;5:116.

Nadal J, Daien V, Audemard D, Jeanjean L. Pourfour du Petit syndrome: a rare association with cluster headache. Ophthalmic Plast Reconstr Surg. 2019;35:e15-e16. doi: 10.1097/IOP.0000000000001281.

Collongues N, Labouret P, Speeg C, de Seze J. A case of recurrent facial pain associated with a Pourfour du Petit syndrome: a new entity? Headache. 2014;54:373-7. doi: 10.1111/head.12137.

Sánchez-de la Torre JR, Drake-Pérez M, Casado A, Palacio-Portilla EJ, Revilla M, Vázquez-Higuera JL, et al. Persistent isolated mydriasis as an early sign of internal carotid artery dissection: Pourfour du petit syndrome. Clin Neurol Neurosurg. 2019;182:70-2. doi: 10.1016/j.clineuro.2019.04.030

Comitê de Classificação das Cefaleias da Sociedade Internacional de Cefaleias. Classificação Internacional de Cefaleias, 3a edição. Sinapse. 2018; 18 supl 2:1-171.

Drummond PD. The site of sympathetic deficit in cluster headache. Headache. 1996;36:3-9. doi: 10.1046/j.15264610.1996.3601003.x.

Downloads

Published

2024-04-20

How to Cite

1.
Gonçalo Pinheiro R, Peres J, Tojal R, Parreira E. Cluster Headache Secondary to Trauma Presenting with Unilateral Mydriasis. Sinapse [Internet]. 2024 Apr. 20 [cited 2025 Jan. 22];22(2):87-90. Available from: https://sinapse.pt/index.php/journal/article/view/69

Issue

Section

Case Reports