title: Cluster headache: When to worry? Two case reports.
abstract: Background The clinical criteria for cluster headache (CH) are included in Chapter 3 of the International Classification of Headache Disorders, 3rd beta edition (ICHD-III). CH may sometimes be secondary to other pathologies. Case reports We report two patients in whom the clinical features of CH initially fulfilled the ICHD-III criteria, but who later presented some radical modifications in headache natural history as a result of a secondary pathology. The first case of CH was secondary to a pontine cavernous angioma and the second to a cerebral venous thrombosis. Conclusion We highlight the importance of clinical modifications of CH that could suggest clinical investigations should be performed or repeated to exclude a secondary pathology in a previously diagnosed cluster headache. Some of the pathological mechanisms of CH and brain lesions are discussed.
authors.affiliation: 1 Headache Centre, Department of Neurosciences, University of Padua, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Bellamio
authors.affiliation: 2 Neuroradiology Unit, Department of Medicine, University of Padua, Italy.
authors.forename: Mariagiulia
authors.initials: M
authors.lastname: Anglani
authors.affiliation: 3 Headache Centre, Neurological Division, SS Giovanni e Paolo Hospital, Venice, Italy.
authors.forename: Federico
authors.initials: F
authors.lastname: Mainardi
authors.affiliation: 1 Headache Centre, Department of Neurosciences, University of Padua, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Zanchin
authors.affiliation: 1 Headache Centre, Department of Neurosciences, University of Padua, Italy.
authors.forename: Ferdinando
authors.initials: F
authors.lastname: Maggioni
mesh_terms: D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000150:complications / Q000000981:diagnostic imaging*; D003027:Cluster Headache / Q000000981:diagnostic imaging* / Q000209:etiology; D006392:Hemangioma, Cavernous / Q000150:complications / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D020246:Venous Thrombosis / Q000150:complications / Q000000981:diagnostic imaging*
keywords: Cluster headache; cavernous angioma; cerebral venous thrombosis; cluster headache mechanism; multiple sclerosis; secondary cluster headache