Article Text
Summary
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.
- Headache (including Migraines)
- Stroke
- Pupil
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Footnotes
Contributors All authors made substantial contribution to the conception, design and revision of the draft. AME was involved in the management and follow-up of the patient and wrote the manuscript. LS revised the manuscript and provided the MRI images. CS examined the patient and revised the manuscript. All authors were involved in the final approval of the version to be published.
Competing interests None declared.
Patient consent Obtained.
Provenance and peer review Not commissioned; externally peer reviewed.