title: Cardiac cephalalgia: one case with cortical hypoperfusion in headaches and literature review.
abstract: BACKGROUND
  Cardiac cephalalgia (CC) is a rare disease occurring during an episode of myocardial ischemia and relieved by nitroglycerine. Though more than 30 cases of CC have been reported since 1997, the mechanism is yet obscure. Herein, a case of CC is presented and discussed in relevance with previous literature to propose a novel hypothesis about the mechanism of CC.
  
  
  METHODS
  A CC patient with cortical hypoperfusion during headache attacks was presented, which has never been reported. All published cases of CC via PubMed ( http://www.ncbi.nlm.nih.gov/pubmed ) in English literature, between 1997 and 2016, were reviewed.
  
  
  RESULTS
  A patient suffering from CC presented a cerebral hypoperfusion during a headache attack. This phenomenon had not been observed since CC was introduced in 1997. The literature review summarized the clinical presentations, neuroimaging features, ECG, and coronary angiography features of 35 CC patients.
  
  
  CONCLUSIONS
  Based on the phenomenon of hypoperfusion in the event of a headache, the vessel constriction hypothesis was proposed including two potential physiological mechanisms underlying the pathophysiology of CC.
authors.affiliation: The Department of Geriatric Neurology, Chinese PLA General Hospital, Beijing, China.
authors.forename: Miao
authors.initials: M
authors.lastname: Wang
authors.affiliation: The Outpatient Department of Fuxing Road No. 7, the First Affiliated Hospital of PLA General Hospital, Beijing, China.
authors.forename: Lu
authors.initials: L
authors.lastname: Wang
authors.affiliation: The Department of of Cardiology, Chinese PLA General Hospital, Beijing, China.
authors.forename: Changfu
authors.initials: C
authors.lastname: Liu
authors.affiliation: The Department of of Radiology, Chinese PLA General Hospital, Beijing, China.
authors.forename: Xiangbing
authors.initials: X
authors.lastname: Bian
authors.affiliation: Department of Neurology, Chinese PLA General Hospital, Fuxing Road 28, Haidian District, Beijing, 100853, China. dong_zhaozhao@126.com.
authors.forename: Zhao
authors.initials: Z
authors.lastname: Dong
authors.affiliation: Department of Neurology, Chinese PLA General Hospital, Fuxing Road 28, Haidian District, Beijing, 100853, China.
authors.forename: Shengyuan
authors.initials: S
authors.lastname: Yu
mesh_terms: D000328:Adult; D002540:Cerebral Cortex / Q000098:blood supply* / Q000000981:diagnostic imaging*; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods; D006261:Headache / Q000000981:diagnostic imaging* / Q000209:etiology; D006801:Humans; D008297:Male; D017202:Myocardial Ischemia / Q000150:complications* / Q000000981:diagnostic imaging*; D059906:Neuroimaging / Q000379:methods
keywords: Cardiac cephalalgia; Clinical features; Neuroimages; Pathophysiology