title: Cluster headache: to scan or not to scan.
abstract: By definition, cluster headache (CH) is not caused by underlying structural pathology. However, patients with CH or CH-like syndromes and an associated structural lesion have been described. In many cases it is difficult to establish a causal relation between the headache syndrome and the lesion. We reviewed the literature for symptomatic CH or CH-like cases in which causality was very likely, and we found that even typical CH with a typical episodic time pattern and a response to typical CH treatment can be caused by underlying structural pathology such as a pituitary tumor. Based on this small retrospective series of case reports, it is impossible to give advice about neuroimaging. If neuroimaging is considered, MRI (not CT) is the investigation of choice.
authors.affiliation: Department of Neurology, K5-Q, Leiden University Medical Centre, PO Box 9600, 2300 RC Leiden, The Netherlands. i.favier@lumc.nl
authors.forename: Irene
authors.initials: I
authors.lastname: Favier
authors.forename: Joost
authors.initials: J
authors.lastname: Haan
authors.forename: Michael D
authors.initials: MD
authors.lastname: Ferrari
mesh_terms: D000700:Analgesics / Q000627:therapeutic use; D003027:Cluster Headache / Q000175:diagnosis* / Q000628:therapy; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D012189:Retrospective Studies
chemical_list: D000700:Analgesics