Superficial artery aneurysms underlying nummular headache--2 cases and proposed diagnostic work-up.
BACKGROUND
Nummular headache, considered a primary headache in the 3rd edition of the International Classification of Headache Disorders, has nonetheless been attributed in several occasions to underlying epicranial anomalies.


METHODS
Vascular imaging of the head in 2 patients with nummular headache revealed fusiform aneurysms of the scalp vessel in close relation to the painful area. One of the patients underwent surgical resection of the aneurysm with excellent response. A response to triptans was noted in both.


CONCLUSIONS
In selected patients with nummular headache, vascular imaging of the scalp may reveal anomalies amenable to surgical treatment or triptan administration, sometimes resulting in disappearance of the pain.
Department of Neurology, Hospital Clínico San Carlos, Universidad Complutense, Madrid, Spain.
Pedro
P
López-Ruiz
María-Luz
ML
Cuadrado
Angel
A
Aledo-Serrano
Almudena
A
Alonso-Oviés
Jesús
J
Porta-Etessam
Tomás
T
Ganado
D000368:Aged; D000783:Aneurysm / Q000150:complications* / Q000473:pathology; D002533:Cerebral Angiography; D006261:Headache / Q000209:etiology* / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012535:Scalp / Q000098:blood supply; D013699:Temporal Arteries / Q000473:pathology; D018615:Ultrasonography, Doppler, Color
epicranial headache; fusiform aneurysm; nummular headache; occipital artery; superficial temporal artery; triptan