Sanin L C, Mathew N T, Ali S
Houston Headache Clinic, TX 77004.
Headache. 1993 Jul-Aug;33(7):369-71. doi: 10.1111/j.1526-4610.1993.hed3307369.x.
Three cases with periodicity and pain profile characteristic of episodic cluster headache, whose headaches were solely confined to the regions of the head and neck outside the trigeminal territory, are reported. Two were females, who had associated nausea and vomiting with severe attacks. The male patient exhibited autonomic symptoms in the eye during the attacks. Alcohol induced headache in one. All three patients responded to anticluster headache therapy. These cases are illustrative of a wider spectrum of clinical manifestations of cluster headache than was originally recognized. They question the theory that cluster headache may be due to a lesion involving the cavernous sinus. One the other hand, it points to involvement of a more complex pain circuit consisting of upper cervical nerves, posterior fossa innervation, trigeminal system and the autonomic pathways.
报告了3例具有发作性丛集性头痛的周期性和疼痛特征的病例，其头痛仅局限于三叉神经区域以外的头颈部区域。2例为女性，严重发作时伴有恶心和呕吐。男性患者发作时眼部出现自主神经症状。1例患者饮酒可诱发头痛。所有3例患者对抗丛集性头痛治疗均有反应。这些病例表明丛集性头痛的临床表现范围比最初认识的更广。它们对丛集性头痛可能由海绵窦病变引起的理论提出了质疑。另一方面，这表明涉及由上颈神经、后颅窝神经支配、三叉神经系统和自主神经通路组成的更复杂的疼痛回路。
