Resolution of paroxysmal hemicrania after resection of intracranial meningioma.
Paroxysmal hemicrania is a trigeminal autonomic cephalalgia first described in 1976, characterized by episodic attacks of excruciating unilateral periorbital and temporal stabbing, pulsatile, craw-like, or boring headaches lasting 2 - 30 minutes, accompanied by autonomic features, and alleviated by indomethacin. Paroxysmal hemicrania is divided into an episodic or chronic form, depending on the duration and frequency of the attacks. We describe a case of paroxysmal hemicrania in a patient with a contralateral anterior clinoid meningioma, which resolved after tumor resection. Most cases of autonomic cephalgias are primary headaches and not caused by underlying intracranial structural lesions. Based on our patient and a literature review of secondary causes of trigeminal autonomic cephalalgias, we recommend that all patients with trigeminal autonomic cephalalgias including paroxysmal hemicrania undergo neuroimaging studies. The preferred neuro-radiologic procedure should be a cranial MRI to exclude underlying structural intracranial lesions, particularly in the sellar and parasellar regions.
Dafer
Rima M
RM
Loyola University, Chicago, IL, USA. rdafer@lumc.edu
Hocker
Sara
S
Kumar
Ragasri
R
McGee
Jan
J
Jay
Walter M
WM
D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008577:Meningeal Neoplasms / Q000175:diagnosis / Q000601:surgery*; D008579:Meningioma / Q000175:diagnosis / Q000601:surgery*; D008875:Middle Aged; D051302:Paroxysmal Hemicrania / Q000175:diagnosis / Q000503:physiopathology*