Studies on Cerebral and Ocular Circulation in a Patient With Cluster Headache

Broch, A; Hørven, Ivar; Nornes, Helge; Sjaastad, Ottar; Tønjum, Asbjørn M.

doi:10.1111/j.1526-4610.1970.hed1001001.x

Cited by 33 publications

(17 citation statements)

References 4 publications

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“…13 A case report of a patient with headaches describes increased intraocular pressure. 27 In a recent study, we have shown that the light delay is a sensitive indicator of increased ocular pressure. 11 In the present series, all patients save two had normal light latency.…”

Section: Commentmentioning

confidence: 96%

The Pupil and Headaches

Hermán

1983

Headache

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SYNOPSIS Pupillography before and after Cocaine eye drops was performed in twenty patients subject to vascular headaches. 65% had anisocoria which after Cocaine eye drops increased to 90%. The smaller pupil was not necessarily on the hemicrania side. Lid droop was observed in nine patients. In ten, the eyelid droop persisted after Cocaine eye drops. The pupil size was not significantly smaller than in a normal group and it was round in all but two cases. These findings suggest that patients with cluster and migraine headache have a subtle chronic sympathetic deficiency which affects both the pupil and eyelid. This deficiency may increase during the acute phase, at times causing a prominent Horner Syndrome. Adrenaline deficiency is locally responsible for these changes. No significant changes were found between cluster and vascular headache patients in this small sample. Pupillography and sympathomimetic eye drops are objective tests in the diagnosis of vascular headache in clinically difficult cases; they are a painless expedient procedure.

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Section: Commentmentioning

confidence: 96%

The Pupil and Headaches

Hermán

1983

Headache

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“…Regarding those changes in the internal carotid artery: Hfrven et al 34 An increased intraocular pressure and indentation pulse, as described by Broch et al, 36 suggested the possibility of dilatation of the ophthalmic or internal carotid arteries. On Ekbom's 35 angiographic study of one patient, dilatation of the ophthalmic artery was indeed noted.…”

Section: Pathways and Pathogenesismentioning

confidence: 98%

“…and I.P. (Broch et al) 36 Dilatation/angiography (Ekbom et al) 35 Supraorbital and Frontal Constriction/Doppler & thermography (Kudrow) 37 Anthony 38 and Sjaastad 39 independently cited evidence of increased urinary excretion and blood concentration of histamine in cluster patients when compared with migraine subjects. No changes in serotonin levels among cluster patients were found in the latter study.…”

Section: Table 11mentioning

confidence: 99%

Cluster Headache: Diagnosis and Management

Kudrow

1979

Headache

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“…1). CIP amplitudes increased markedly during attacks (ie, from 48 to 96 microns on the symptomatic side vs 44 to 48 microns on the nonsymptomatic side) [15]. A series of similar patients (n = 7) could be examined later.…”

Section: Ocular Parametersmentioning

confidence: 99%

“…This was studied by electroflowmetry, which measures flow directly from the carotid arteries; no changes were observed during attack [15]. Cerebral blood flow also was measured with the intra-arterial 133 xenon clearance technique [6].…”

Section: Cerebral Blood Flowmentioning

confidence: 99%

Chronic paroxysmal hemicrania: From the index patient to the disease

Sjaastad

2006

Current Science Inc

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The first patient with chronic paroxysmal hemicrania (CPH), a 41-year-old woman, first seen in 1961, was followed until an adequate treatment was found, 12 years later. Clinically, attack frequency and duration differed widely from the general pattern of cluster headache. Ocular variables, such as intraocular pressure and corneal indentation pulse amplitudes, also differed in our case (clear symptomatic side increment during attacks) and cluster headache. Pupil reactions to directly and indirectly acting sympathicomimetic drugs were also vastly different in our case and cluster headache: no signs of Horner s syndrome in our patient, while cluster headache exhibits a "Horner-like pattern." In cluster headache, there is a relative hypohidrosis in the forehead on the symptomatic side if body temperature is increased, and a clear hyperhidrosis on direct parasympathomimetic stimulation. This was not so in our case. Indomethacin was highly effective in our case, while "cluster headache drugs," such as ergotamine/sumatriptan, were ineffective. Indomethacin was inactive in cluster headache. Accordingly, our case seemed to differ decisively from cluster headache: CPH had been discovered.

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Studies on Cerebral and Ocular Circulation in a Patient With Cluster Headache

Cited by 33 publications

References 4 publications

The Pupil and Headaches

The Pupil and Headaches

Cluster Headache: Diagnosis and Management

Chronic paroxysmal hemicrania: From the index patient to the disease

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