An unusual diagnostic route: Pediatric case of a mesencephalic cavernoma presenting as cluster headache
Cluster headaches are characterized by painful unilateral periorbital attacks accompanied by dysautonomic symptoms. Although cluster headaches are classified as a primary headache disorder, a few cases of inflammatory, vascular or neoplastic conditions have been reported to cause or mimic cluster he...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2021-12-01
|
| Series: | Interdisciplinary Neurosurgery |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2214751921002188 |
| _version_ | 1818358668616269824 |
|---|---|
| author | Nathalie Gilis Christophe Fricx Valentina Lolli Olivier De Witte |
| author_facet | Nathalie Gilis Christophe Fricx Valentina Lolli Olivier De Witte |
| author_sort | Nathalie Gilis |
| collection | DOAJ |
| description | Cluster headaches are characterized by painful unilateral periorbital attacks accompanied by dysautonomic symptoms. Although cluster headaches are classified as a primary headache disorder, a few cases of inflammatory, vascular or neoplastic conditions have been reported to cause or mimic cluster headaches. This raises the question as to the possible causal relationship between symptoms and an underlying structural lesion that may potentially interfere with the trigemino-autonomic reflex.We hereby report the first pediatric case of a brainstem cavernoma causing cluster headache-like symptoms. Of note, the child experienced pain relief after surgery.With regards to the pathophysiology, the observed ptosis observed in our child during the painful crises might be explained by mass effect of the cavernorma on the cisternal portion of the third cranial nerve. In addition, chronic inflammation of mesencephalic and motor nuclei of the trigeminal nerve by thalamo-pedoncular edema surrounding the lesion may have participated to painful pathways.This case illustrates that cluster headaches may occasionally be secondary to an underlying lesion. This advocates the need for MRI screening, especially as neurosurgical intervention may offer significant symptomatic relief and an improvement in the quality of life of these patients. |
| first_indexed | 2024-12-13T20:32:40Z |
| format | Article |
| id | doaj.art-fb6d45c038684295b66ae250560e6e2e |
| institution | Directory Open Access Journal |
| issn | 2214-7519 |
| language | English |
| last_indexed | 2024-12-13T20:32:40Z |
| publishDate | 2021-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Interdisciplinary Neurosurgery |
| spelling | doaj.art-fb6d45c038684295b66ae250560e6e2e2022-12-21T23:32:23ZengElsevierInterdisciplinary Neurosurgery2214-75192021-12-0126101306An unusual diagnostic route: Pediatric case of a mesencephalic cavernoma presenting as cluster headacheNathalie Gilis0Christophe Fricx1Valentina Lolli2Olivier De Witte3Department of Neurosurgery, Erasmus Hospital, Route de Lennik 808, Brussels, Belgium; Corresponding author at: Route de Lennik, 808, 1070 Brussels Belgium.Department of Pediatrics, Erasmus Hospital, Route de Lennik 808, Brussels, BelgiumDepartment of Radiology, Erasmus Hospital, Route de Lennik 808, Brussels, BelgiumDepartment of Neurosurgery, Erasmus Hospital, Route de Lennik 808, Brussels, BelgiumCluster headaches are characterized by painful unilateral periorbital attacks accompanied by dysautonomic symptoms. Although cluster headaches are classified as a primary headache disorder, a few cases of inflammatory, vascular or neoplastic conditions have been reported to cause or mimic cluster headaches. This raises the question as to the possible causal relationship between symptoms and an underlying structural lesion that may potentially interfere with the trigemino-autonomic reflex.We hereby report the first pediatric case of a brainstem cavernoma causing cluster headache-like symptoms. Of note, the child experienced pain relief after surgery.With regards to the pathophysiology, the observed ptosis observed in our child during the painful crises might be explained by mass effect of the cavernorma on the cisternal portion of the third cranial nerve. In addition, chronic inflammation of mesencephalic and motor nuclei of the trigeminal nerve by thalamo-pedoncular edema surrounding the lesion may have participated to painful pathways.This case illustrates that cluster headaches may occasionally be secondary to an underlying lesion. This advocates the need for MRI screening, especially as neurosurgical intervention may offer significant symptomatic relief and an improvement in the quality of life of these patients.http://www.sciencedirect.com/science/article/pii/S2214751921002188Pediatric cluster headacheSecondary cluster headacheBrainstem cavernoma |
| spellingShingle | Nathalie Gilis Christophe Fricx Valentina Lolli Olivier De Witte An unusual diagnostic route: Pediatric case of a mesencephalic cavernoma presenting as cluster headache Interdisciplinary Neurosurgery Pediatric cluster headache Secondary cluster headache Brainstem cavernoma |
| title | An unusual diagnostic route: Pediatric case of a mesencephalic cavernoma presenting as cluster headache |
| title_full | An unusual diagnostic route: Pediatric case of a mesencephalic cavernoma presenting as cluster headache |
| title_fullStr | An unusual diagnostic route: Pediatric case of a mesencephalic cavernoma presenting as cluster headache |
| title_full_unstemmed | An unusual diagnostic route: Pediatric case of a mesencephalic cavernoma presenting as cluster headache |
| title_short | An unusual diagnostic route: Pediatric case of a mesencephalic cavernoma presenting as cluster headache |
| title_sort | unusual diagnostic route pediatric case of a mesencephalic cavernoma presenting as cluster headache |
| topic | Pediatric cluster headache Secondary cluster headache Brainstem cavernoma |
| url | http://www.sciencedirect.com/science/article/pii/S2214751921002188 |
| work_keys_str_mv | AT nathaliegilis anunusualdiagnosticroutepediatriccaseofamesencephaliccavernomapresentingasclusterheadache AT christophefricx anunusualdiagnosticroutepediatriccaseofamesencephaliccavernomapresentingasclusterheadache AT valentinalolli anunusualdiagnosticroutepediatriccaseofamesencephaliccavernomapresentingasclusterheadache AT olivierdewitte anunusualdiagnosticroutepediatriccaseofamesencephaliccavernomapresentingasclusterheadache AT nathaliegilis unusualdiagnosticroutepediatriccaseofamesencephaliccavernomapresentingasclusterheadache AT christophefricx unusualdiagnosticroutepediatriccaseofamesencephaliccavernomapresentingasclusterheadache AT valentinalolli unusualdiagnosticroutepediatriccaseofamesencephaliccavernomapresentingasclusterheadache AT olivierdewitte unusualdiagnosticroutepediatriccaseofamesencephaliccavernomapresentingasclusterheadache |