Resolution of paroxysmal hemicrania after resection of intracranial meningioma.

Abstract

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.

• Authors: Rima M Dafer, Sara Hocker, Ragasri Kumar, Jan McGee, Walter M Jay
• Journal: Seminars in ophthalmology (Semin Ophthalmol) 2010 Jan-Mar Vol. 25 Issue 1-2 Pg. 34-5 ISSN: 1744-5205 [Electronic] England
• PMID: 20148710 (Publication Type: Case Reports, Journal Article)

Topics

• Female
• Humans
• Magnetic Resonance Imaging
• Meningeal Neoplasms (diagnosis, surgery)
• Meningioma (diagnosis, surgery)
• Middle Aged
• Paroxysmal Hemicrania (diagnosis, physiopathology)