Headache in cervicocerebral artery dissection

Persistent headache attributed to past cervicocephalic artery dissection: clinical characteristics and contributors to headache persistence

“…Headache/cervical pain was the first manifestation of the dissection in more than half of the cases, especially in our HPCCAD group, in which 82% had a headache as the first symptom, commonly in association with other symptomatology. Onset of headache around the time of the dissection is well described in the literature (5,6). Kim et al (5) suggested that acute occipital-nuchal severe pain was suggestive of CCAD, which translated into our work, where almost half of the patients presented with nuchal/cervical features during the episode, frequently describing the pain as severe.…”

“…Acute headache or facial/neck pain in a CCAD can be a warning sign of subsequent stroke; thus, an early diagnosis has the potential to be lifesaving (5). Most patients with CCAD were between the third and fifth decade of life, and often with no identified vascular risk factors (5,6). Headache/cervical pain was the first manifestation of the dissection in more than half of the cases, especially in our HPCCAD group, in which 82% had a headache as the first symptom, commonly in association with other symptomatology.…”

“…Although headache persistence after CCAD (HPCCAD) has been vastly under-documented as a long-term consequence of this event, it can be a major contributor to a decline in the overall quality of life (6,(8)(9)(10). In the literature, about a quarter of patients with CCAD had a persistent headache at six months post-event (8); another study reported 19% of HPCCAD at 36 months post-event (9).…”

An atypical cause of headache

“…However, only 2% of strokes are due to dissections. One of the main symptoms is headache, which occurs in more than 70% of the patients,2 followed by Horner’s syndrome and cerebral or retinal ischaemia in carotid dissections, and ischaemia of the posterior circulation in vertebral dissection. The pain of vertebral artery dissection is commonly confused as musculoskeletal.…”

Practical use of non-steroidal anti-inflammatory drugs in relieving recurrent headaches

“…Односторонняя боль в шее или голове, особенно после резкого движения в шейном отделе позвоночника, травмы, длительного вынужденного положения (например, в кресле стоматолога или при работе за компьютером), может быть вызвана диссекцией церебральных артерий, которая при наличии неврологической симптоматики часто является причиной инсульта у молодых пациентов. При отсутствии травмы в анамнезе у данных пациентов часто выявляются признаки дисплазии соединительной ткани [21]. Присутствие синдрома Горнера, amaurosis fugax часто связано с диссекцией черепных артерий [22].…”