title: Trigeminal autonomic cephalgia with periorbital ecchymosis, ocular hemorrhage, hypertension and behavioral alterations.
abstract: We describe a 38-year-old male in whom severe unilateral headache was associated with marked palpebral edema, periorbital ecchymosis, lacrimation, conjunctival injection, nasal congestion and rhinorrhea. A second, less severe headache form developed subsequently. The patient often presented severe labile hypertension and behavioral disturbances during the crises, and there was an episode of intra-ocular hemorrhage. General, neurological and ophthalmological examinations revealed nothing remarkable. We discuss possible pathogenetic mechanisms and the nosology of this case within the trigeminal autonomic cephalgias.
authors.affiliation: Department of Neurology, C. Besta Neurological Institute, Via Celoria 11, 20133 Milan, Italy Department of Neurology, Policlinico S. Pietro, Ponte S. Pietro, Bergamo, Italy Department of Ophthalmology, Scientific Institute S. Raffaele Hospital, Milan, Italy.
authors.forename: Angelo
authors.initials: A
authors.lastname: Attanasio
authors.forename: Domenico
authors.initials: D
authors.lastname: D'Amico
authors.forename: Fabio
authors.initials: F
authors.lastname: Frediani
authors.forename: Massimo
authors.initials: M
authors.lastname: Leone
authors.forename: Licia
authors.initials: L
authors.lastname: Grazzi
authors.forename: Stefania
authors.initials: S
authors.lastname: Bianchi-Marzoli
authors.forename: Susanna
authors.initials: S
authors.lastname: Usai
authors.forename: Gennaro
authors.initials: G
authors.lastname: Bussone
mesh_terms: D000328:Adult; D001341:Autonomic Nervous System / Q000503:physiopathology; D003027:Cluster Headache / Q000150:complications; D004438:Ecchymosis / Q000209:etiology*; D005128:Eye Diseases / Q000209:etiology*; D006261:Headache / Q000150:complications* / Q000503:physiopathology; D006470:Hemorrhage / Q000209:etiology*; D006801:Humans; D006973:Hypertension / Q000209:etiology*; D008297:Male; D001523:Mental Disorders / Q000209:etiology*; D008881:Migraine Disorders / Q000150:complications; D009916:Orbital Diseases / Q000209:etiology*; D014276:Trigeminal Nerve / Q000503:physiopathology*