Central nervous system superficial siderosis, headache, and epilepsy.
Almost 95 cases of superficial siderosis of the central nervous system have been reported in the literature. These patients showed a clinical syndrome characterized by ataxia, deafness, pyramidal system involvement, and mental deterioration with xanthochromic cerebrospinal fluid and neuroradiological findings of hemosiderin deposits. About 30% of the patients had headache as an accompanying symptom. In the present case report, we describe a 33-year-old man with the typical clinical features of superficial siderosis, who complained, since aged 8, of a severe recurrent frontal headache often associated with loss of consciousness occurring after at least 2 hours of pain. The MRI and CSF findings were consistent with subarachnoid bleeding. In our patient, headache due to meningeal irritation by subarachnoid blood induced seizures as a probable reflex of extreme pain. Carbamazepine and nimodipine prophylaxis dramatically reduced the frequency of headaches and seizures.
Department of Neurology, IRCCS H. S. Raffaele, University of Milan, Italy.
S
S
Iannaccone
V
V
Golzi
B
B
Sferrazza
F
F
de Rino
S
S
Smirne
L
L
Ferini-Strambi
D000328:Adult; D002493:Central Nervous System Diseases / Q000209:etiology*; D006259:Craniocerebral Trauma / Q000150:complications; D004827:Epilepsy / Q000209:etiology*; D006261:Headache / Q000209:etiology*; D006801:Humans; D008297:Male; D012806:Siderosis / Q000209:etiology*; D013345:Subarachnoid Hemorrhage / Q000150:complications*