Sjaastad O, Saunte C, Fredriksen T A, de Souza Carvalho D, Fragoso Y D, Dale L G, Hørven I
Department of Neurology, Regionsykehuset i Trondheim, Norway.
Cephalalgia. 1988 Jun;8(2):111-20. doi: 10.1046/j.1468-2982.1988.0802111.x.
A 56-year-old, previously reported woman with cluster headache-like headache with bouts of unilateral (the side of predominance changing through the years) severe headache had a familial history (three generations) of partial Hageman factor deficiency and bleeding episodes. A giant aneurysm was found to be lodged in the anterior communicating artery on the left side. Clinically, the features were atypical for cluster headache: onset at a young age (14 years), episodes of retrobulbar neuritis appearing at the side of pain, etc. Studies of forehead sweating indicated that the right side was the pathologic one, from an autonomic point of view, as did pupillometric studies. However, during attacks, which were left-sided at the time, forehead sweating was marked laterally on the left side and on the upper eyelid, but not on the right. The "signal" usually reaching the autonomically stigmatized side during attacks of cluster headache, therefore, did not seem to reach the sweat glands on that (the right) side during the attack in the present case. This headache may, therefore, be distinct from cluster headache, both from a clinical and from an autonomic function point of view.
一名56岁的女性，曾有丛集性头痛样头痛病史，伴有反复发作的单侧（多年来优势侧不断变化）严重头痛，有家族病史（三代人），存在部分哈格曼因子缺乏和出血发作情况。发现一个巨大动脉瘤位于左侧前交通动脉。临床上，其特征不符合丛集性头痛：发病年龄较轻（14岁），疼痛侧出现球后视神经炎发作等。前额出汗研究表明，从自主神经角度来看，右侧是病变侧，瞳孔测量研究结果也是如此。然而，在当时为左侧发作期间，左侧前额外侧和上眼睑出汗明显，而右侧没有。因此，在丛集性头痛发作时通常到达自主神经受影响侧的“信号”，在本病例发作期间似乎没有到达该（右侧）侧的汗腺。因此，从临床和自主神经功能角度来看，这种头痛可能与丛集性头痛不同。
