Orbital Phlebography in Patients with Cluster Headache

Hannerz, Jan; Ericson, K.; Bergstrand, G.

doi:10.1046/j.1468-2982.1987.0703207.x

Cited by 62 publications

(61 citation statements)

References 20 publications

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“…Orbital phlebography in patients with CPH has revealed signs of venous vasculitis (10, 11) with similar findings to those reported in THS (12), other unilateral headache syndromes like CH (13) and SUNCT (shortlasting unilateral neuralgiform headache with conjunctival injection and tearing) (14). There are also reports of patients with periorbital pain resembling that of THS and visual loss without ophthalmoplegia (15), as was described here in case 2.…”

Section: Discussionsupporting

confidence: 81%

A CPH-Like Picture in Two Patients with an Orbitocavernous Sinus Syndrome

1997

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Section: Discussionsupporting

confidence: 81%

A CPH-Like Picture in Two Patients with an Orbitocavernous Sinus Syndrome

1997

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“…The pathological findings included narrowing/calibre variations of the superior ophthalmic vein and partial occlusion of the cavernous sinus. However, similar findings were also described in CH [57,58] and SUNCT [11,59]. In fact, when the frequency of pathological findings in series of non-medicated patients with Tolosa-Hunt syndrome [55,56], episodic CH [58] and SUNCT [59] were compared, the percentages of pathological results amounted to around 70%, 60% and 80%, respectively.…”

Section: Laboratory Investigationssupporting

confidence: 75%

Cluster headache and SUNCT: similarities and differences

Kruszewski

Pareja

Caminero³

et al. 2001

J Headache Pain

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IntroductionOur first case of SUNCT was found in 1978 [1], and a total of three cases were later published under the common name "shortlasting, unilateral, neuralgiform headache attacks with conjunctival injection and tearing" in 1989 [2]. Currently, SUNCT is defined by the International Association for the Study of Pain (IASP) as "Repetitive paroxysms of unilateral shortlasting pain, usually 15-120 seconds duration, mainly in the ocular and the periocular areas, of a neuralgiform nature and moderate to severe intensity, usually appearing only during daytime and accompanied by ipsilateral marked conjunctival injection, lacrimation, a low to moderate degree of rhinorrhea, and subclinical forehead sweating", and belongs to the group of neuralgias of the head and face [3]. Furthermore, the pain paroxysms accompanied by autonomic phenomena tend to appear in cluster periods, and there is a clear male preponderance in SUNCT [3]. Thus, SUNCT has even been considered to be in the same group as cluster headache (CH) [4,5]. Abstract SUNCT is probably a distinct syndrome, although it shares some common features with cluster headache (CH): male sex preponderance, clustering of attacks, unilaterality of headache without sideshift, pain of non-pulsating type with its maximum in the periocular area, ipsilateral autonomic phenomena (e.g. conjunctival injection, lacrimation, rhinorrhea, increased forehead sweating), systemic blood pressure increment with heart rate decrement, blood flow velocity decrement in the middle cerebral artery, and hyperventilation. In spite of these similarities, SUNCT syndrome differs clearly from CH as regards a number of clinical variables, such as duration, intensity, frequency, and nocturnal preponderance of attacks. The two syndromes also differ markedly as regards precipitation of attacks, the usual age at onset, and efficacy of various treatment alternatives.Laboratory investigations have disclosed differences as regards presence or absence of Horner-like picture and possibly also the respiratory sinus arrhythmia pattern. All in all, these differences seem sufficiently ponderous to make it likely that SUNCT syndrome and CH differ essentially. SUNCT seems to be a "neuralgiform" headache, but different from trigeminal neuralgia.

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“…[2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] Recently, pathophysiological interest has been focused on basal midline structures and in particular, the cavernous sinus. [17][18][19][20][21][22][23] We report a case of clusterlike headache associated with an intrasellar pituitary adenoma causing acromegaly. The relevance of the tumor location and its possible implications for the symptomatology, particularly with respect to sympathetic dysfunction, are discussed.…”

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confidence: 99%

Clusterlike Headache in a Patient With a Pituitary Adenoma. With a Review of Literature

1996

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A man had left-sided atypical clusterlike headache for II years before he developed symptoms and signs consistent with acromegaly. Preoperative evaluation revealed raised levels of somatomedin C and growth hormone. An MR indicated a left-sided intrasellar mass measuring 8 x 7.5 x 10 mm. He underwent surgery and microscopy confirmed the diagnosis of a benign hypophyseal adenoma. Postoperatively, the acromegalic features regressed, and for the last 4 years the patient has been completely free from headache attacks. On pharmacological testing of the pupillary response to 19 and 5% phenylephrine and 2% tyramine solutions, there was no convincing evidence of persistent sympathetic dysfunction on the earlier symptomatic side.Key words: acromegaly, clusterlike headache, phenylephrine pituitary adenoma, pupil, tyramine Abbreviations: GH growth hormone (Headache 1996;36:184-188) The pathophysiology of cluster headache remains unclear. In most instances, every extensive neurological and neuroradiological examinations will be normal. 1 However. symptomatic clusterlike headache has been reported in a variety of pathological conditions with varying locations. [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] Recently, pathophysiological interest has been focused on basal midline structures and in particular, the cavernous sinus. [17][18][19][20][21][22][23] We report a case of clusterlike headache associated with an intrasellar pituitary adenoma causing acromegaly. The relevance of the tumor location and its possible implications for the symptomatology, particularly with respect to sympathetic dysfunction, are discussed. CASE HISTORYA 37-year-old man had suffered from left-sided headache attacks for 4 years before he sough medical advice at the Department of Neurology Malmö University Hospital in 1985. His previous history was unremarkable. The headache was strictly left-sided and located behind the eye; radiating towards the left ear, the occiput, and the neck. Because the pain also involved the teeth in the left upper jaw, he had undergone dental treatments, including correction of bite, all of which had been in vain.The attacks occurred with varying intervals of weeks or months. The pain was excruciating, with a stinging and pulsating character. It always started at about the same time in the afternoon and lasted for up to 7 or 8 hours. The patient could only get some relief by a high intake of phenacetin and acetylsalicylic acid. However, by pouring hot water over the neck or by massaging the occipital region on the left side, he could also obtain considerable relief. The pain never sub sided completely before he went to bed. Initially, when the headache attacks started, he thought that attacks could be provoked by intense sunlight, shimmering waves, but also by a cold wind blowing in the face. Whenever he suffered an attack, his left eye was reddened with markedly increased lacrimation. The left nostril was blocked and there was rhinorrhea. During an attack, he did not experience nausea, nor did he ever vomit. Som...

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Orbital Phlebography in Patients with Cluster Headache

Cited by 62 publications

References 20 publications

A CPH-Like Picture in Two Patients with an Orbitocavernous Sinus Syndrome

A CPH-Like Picture in Two Patients with an Orbitocavernous Sinus Syndrome

Cluster headache and SUNCT: similarities and differences

Clusterlike Headache in a Patient With a Pituitary Adenoma. With a Review of Literature

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