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Case Reports: Findings that shed new light on the possible pathogenesis of a disease
Development of a cluster-like headache after a stent-assisted implantation of an endovascular WEB device
  1. Tareq Meyer1,
  2. Alexander Riabikin2 and
  3. Cornelius Johannes Werner1,3
  1. 1Department of Neurology, RWTH Aachen University Medical Faculty, Aachen, Nordrhein-Westfalen, Germany
  2. 2Department of Diagnostic and Interventional Neuroradiology, RWTH Aachen University Medical Faculty, Aachen, Nordrhein-Westfalen, Germany
  3. 3Department of Neurology and Geriatrics, Johanniter-Krankenhaus Genthin-Stendal GmbH, Stendal, Saxony-Anhalt, Germany
  1. Correspondence to Dr Cornelius Johannes Werner; cornelius.werner{at}rwth-aachen.de

Abstract

After interdisciplinary consent, a male patient in his 50s received endovascular treatment of an innocent supraophthalmic aneurysm of the internal carotid artery with a WEB (woven endo bridge) device and stenting. In the medical history, a migraine with aura was reported. A week after intervention, the patient developed an ipsilateral cluster-like headache responsive to classical interventions. Inflammation of the carotid wall near the stent was demonstrated to be associated with the headaches and was responsive to steroid treatment.

The presented case demonstrates that postinterventional headache comprises more headache entities than the often reported migraine and tension-type headache with a considerable impact on the patients’ quality of life. The case supports the vascular hypothesis of cluster headache pathophysiology, potentially contradicting current models and assumptions.

  • Neurology
  • Headache (including migraines)
  • Interventional radiology

http://dx.doi.org/10.1136/bcr-2022-251431

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    Footnotes

    • Contributors TM: substantially contributed to the conception of the work, drafted the first version of the manuscript and critically revised subsequent iterations, approved of the version to be published, accepts full accountability for all aspects of the work. AR: acquired and interpreted relevant data, critically revised the final manuscript revision, approved of the version to be published, accepts full accountability for all aspects of the work. CJW: substantially contributed to the conception of the work, interpreted data and provided theoretical framework, revised the first version of the manuscript and critically revised subsequent iterations, approved of the version to be published, accepts full accountability for all aspects of the work. TM and AR contributed equally to this paper.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.