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Ascending cluster headache: a description of three cases and a review of the literature

C. Serna-Candel, M.L. Cuadrado-Pérez, Á.L. Guerrero-Peral, S. García-Ptacek, J. Porta-Etessam [REV NEUROL 2011;52:412-416] PMID: 21425110 DOI: https://doi.org/10.33588/rn.5207.2010685

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Volumen 52 | Number 07 | Nº of views of the article 10.615 | Nº of PDF downloads 1.266 | Article publication date 01/04/2011

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ABSTRACT

INTRODUCTION It has been previously shown that cluster headache (CH) can involve some extratrigeminal areas. Occipital pain has been recognized in several patients, even as the origin of the attacks. Nevertheless, the proposals of topographic variations of CH have been mainly focused on the location of pain in either supraorbital or infraorbital regions. CASE REPORTS. We report three patients fulfilling International Classification of Headache Disorders criteria for CH whose attacks started with mild or moderate headache at the occipital region and gradually moved forward over 10 to 30 minutes, finally reaching the ipsilateral orbital area. There the pain acquired typical CH features, with severe intensity and ipsilateral autonomic accompaniments.

CONCLUSIONS These descriptions of ascending CH probably reflect pathophysiological mechanisms involving the trigeminocervical complex, and also offer theoretical support for some new therapeutic approaches such as great occipital nerve blockades or occipital neurostimulation. KeywordsAscending cluster headache Cluster headache Occipital pain Trigeminal autonomic cephalalgias Trigeminal spinal nucleus caudalis Trigeminocervical complex CategoriesCefalea y Migraña Dolor

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Nota Clínica

Ascending cluster headache: a description of three cases and a review of the literature