Elhfnawy Ahmed Mohamed, Solymosi László, Sommer Claudia
Department of Neurology, University Hospital of Würzburg, Würzburg, Bayern, Germany.
Department of Neuroradiology, University Hospital of Würzburg, Würzburg, Bavaria, Germany.
BMJ Case Rep. 2017 Jul 31;2017:bcr-2017-220845. doi: 10.1136/bcr-2017-220845.
We present a patient with known episodic cluster headache, who presented with cluster-like headache in the course of internal carotid artery dissection (ICAD) and discuss possible pathophysiological links between the two diseases. It is well known that cluster-like headache could be the presenting symptom of ICAD. However, ICAD occurring in a patient with a known episodic cluster headache was only once previously described. In the end of the manuscript, we propose red flags to help clinicians differentiate between primary cluster headache and cluster-like attacks masking underlying ICAD. Finally, we raise the question whether at least some proportion of those patients with cluster headache and Horner syndrome previously classified as a primary headache disorder might have been secondary cases to ICAD.
我们报告了一名患有已知发作性丛集性头痛的患者，该患者在颈内动脉夹层（ICAD）过程中出现了类似丛集性的头痛，并讨论了这两种疾病之间可能的病理生理联系。众所周知，类似丛集性的头痛可能是ICAD的首发症状。然而，ICAD发生在一名已知发作性丛集性头痛的患者身上，此前仅被描述过一次。在本文末尾，我们提出了一些警示信号，以帮助临床医生区分原发性丛集性头痛和掩盖潜在ICAD的类似丛集性发作。最后，我们提出一个问题，即之前被归类为原发性头痛疾病的至少一部分丛集性头痛和霍纳综合征患者是否可能是ICAD的继发病例。
