[Trigeminal autonomic cephalgias. After initial diagnosis, consider secondary causes].

Trigeminal autonomic cephalgias (TAC) are classified as primary headache syndromes. The use of instrumental procedures including neuroimaging in the diagnostic workup of the TACs is controversially discussed in the literature. Several case reports have been previously published, reporting trigeminal autonomic cephalgias related to structural lesions. We contribute two of our own cases of symptomatic TACs and demonstrate that a "classic" clinical presentation does not preclude a symptomatic etiology. Thus, we advocate a systematic diagnostic evaluation including neuroimaging in every patient presenting with symptoms indicative of TAC for the first time.