title: [Long-lasting, refractory headache after bilateral dissection of the internal carotid artery].
abstract: Headache is usually the first and the most frequent symptom of cervicocephalic arterial dissection. Besides headache ipsilateral Horner's syndrome, cranial nerve palsies, or pulsatile tinnitus are observed. Serious complications of arterial dissection are ischemic strokes, which mostly occur later in the course of time. We report on a patient with spontaneous bilateral carotid artery dissection, who suffered from atypically prolonged, severe, and refractory headache. High-dose administration of nonsteroidal anti-inflammatory drugs as well as opioids were ineffective. Pain relief was only achieved after a 3-day course of corticosteroids (100 mg methylprednisolone/day).
authors.affiliation: Neurologische Klinik, Krankenhaus Merheim, Kliniken der Stadt Köln gGmbH.
authors.forename: J
authors.initials: J
authors.lastname: Kuhn
authors.forename: W
authors.initials: W
authors.lastname: Mueller
authors.forename: A
authors.initials: A
authors.lastname: Harzheim
authors.forename: H
authors.initials: H
authors.lastname: Bewermeyer
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000792:Angiography; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D020215:Carotid Artery, Internal, Dissection / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000503:physiopathology*; D007839:Functional Laterality; D006261:Headache / Q000209:etiology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male
chemical_list: D000305:Adrenal Cortex Hormones; D000894:Anti-Inflammatory Agents, Non-Steroidal