Cluster headache attacks in a woman previously struck by lightning: pathophysiology of the latent period

Abstract

We hypothesize that a relationship between the lightning and the cluster headache-like episodes observed in our patient. This case study may have helped throw some light into the still unknown pathophysiology of this particular type of primary headache.

Latin American consensus on guidelines for chronic migraine treatment

“…The headache pharmacologic treatment should consider: the excessively used medication associated with it; scenario (if out-or in-hospital); drug formulation (if oral or parenteral); drug efficacy regarding pain intensity; its potential to result in addiction; history of intolerance and idiosyncratic responses; pharmacodynamics profile; response to previous acute treatments; and patient's stratification regarding the degree of lack of clinical response with acute treatments 50,51 . There are no class I studies of symptomatic medicines for the acute treatment of individuals with chronic migraine.…”

Cluster headache and intracranial aneurysm

“…Interestingly, a close correspondence was noted between the region of the head injury and the side on which CH later occurred, with a mean latency of nine years. The pathophysiology of the CH latent period is discussed elsewhere [3].…”

“…Pain and vasodilatation appear secondary to an activation of the trigeminal vascular system and the periodicity of the attacks is thought to be due to a dysfunction of the hypothalamic biologic clock mechanisms. Although CH is considered a primary entity, secondary cases have been described [2][3][4][5][6][7][8][9][10][11][12][13][14][15]. In approximately 3%-5% of patients with CH, the syndrome is secondary to diverse cranial structural abnormalities [8], such as: fistula of the superficial temporal artery and occipital horn ventricular xanthoma [8]; arteriovenous malformation [11]; brain metastases [7]; injury to the vertebral artery [5]; sphenoidal sinus aspergilloma [6]; post-traumatic subdural haematoma [4]; brain trauma [4,14]; lightening strike [3] and dental extraction [10].…”

Headache Research and Medical Practice in Brazil: An Historical Overview

“…In addition, he was the author of the first book published on the subject of headache in Latin America, in addition to a series of other books dealing with headache medicine . He also published an extensive series of articles addressing different types of headache, including clinical observations on and the results of pharmacological treatments based on his daily experience with headache sufferers . Unfortunately, the vast majority of his publications were in Portuguese and therefore remained restricted to those with a knowledge of the Portuguese language.…”

“…We will mention a few other Brazilians and the IHS member under whose supervision they studied or worked with: Luiz Paulo Queiroz/Alan M. Rapoport; Fernando Kowacs/Peter Goadsby; Mario Peres/Stephen Silberstein. Marcelo Eduardo Bigal started his training in headache medicine under the supervision of José Geraldo Speciali and Carlos Bordini, finalizing both MSc and PhD theses at Ribeirao Preto School of Medicine‐USP, and receiving postdoctoral training with Richard B. Lipton in New York.…”