1 Headache Center, Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, University of Campania 'Luigi Vanvitelli', Naples, Italy.
2 MRI Research Center SUN-FISM, University of Campania 'Luigi Vanvitelli', Naples, Italy.
Cephalalgia. 2018 Apr;38(4):804-807. doi: 10.1177/0333102417708773. Epub 2017 May 5.
Background Hemicrania continua (HC) is a primary headache syndrome characterized by a unilateral, moderate, continuous headache with exacerbations marked by migrainous and cranial autonomic symptoms. However, clinical phenotypes similar to primary HC may be subtended by several disorders. Case report We report the case of a 62-year-old man experiencing, over the previous year, a headache completely consistent with HC and its absolute responsiveness to indomethacin therapy. Later, the patient developed diplopia caused by sixth cranial nerve palsy ipsilateral to headache. In this frame, clinical, laboratory and neuroimaging characteristics supported the diagnosis of idiopathic hypertrophic pachymeningitis (IHP). Conclusions IHP is a rare fibrosing inflammatory disorder leading to a localized or diffuse dura mater thickening. IHP clinical manifestations are a progressively worsening headache and signs related to cranial nerves involvement and venous sinus thrombosis. Here, we report, for the first time, a HC phenotype subtended by IHP.
背景 慢性偏头痛（HC）是一种原发性头痛综合征，其特征为单侧、中度、持续性头痛，并伴有偏头痛和颅自主神经症状的加剧。然而，与原发性 HC 相似的临床表型可能由多种疾病引起。
病例报告 我们报告了一例 62 岁男性的病例，该患者在过去一年中经历了完全符合 HC 的头痛，且对吲哚美辛治疗有绝对反应。后来，患者出现了与头痛同侧的第六颅神经麻痹导致的复视。在这种情况下，临床、实验室和神经影像学特征支持特发性肥厚性硬脑膜炎（IHP）的诊断。
结论 IHP 是一种罕见的纤维炎性疾病，导致局部或弥漫性硬脑膜增厚。IHP 的临床表现为进行性加重的头痛和与颅神经受累及静脉窦血栓形成相关的体征。在这里，我们首次报告了由 IHP 引起的 HC 表型。
