Imaging in Headache Medicine
Carotid paraganglioma mimicking a cluster headache
Cephalalgia 2014, Vol. 34(13) 1111 ! International Headache Society 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/0333102414530523 cep.sagepub.com
Pauline Malissart1, Anne Ducros1, Pierre Labauge1, Nicolas Menjot De Champfleur2 and Clarisse Carra-Dalliere1
A 60-year-old woman presented a 3 day-history of severe recurrent right periorbital pain, with ipsilateral conjunctival injection and lacrimation, lasting 20 minutes, occurring five times a day. Those features satisfied criteria A to D of cluster headaches (CH) of the International Classification of Headache Disorders (1). Criterion E implies the exclusion of symptomatic etiologies, thus cerebral and cervical MRI imaging was performed, revealing a voluminous ipsilateral carotid paraganglioma (Figure 1). After a complete resection of the paraganglioma, CH was resolved. Several etiologies of secondary CH have already been described, mainly carotid dissections (2,3). Carotid paraganglioma should be added to the list. Conflict of interest None declared.
References Figure 1. Axial cervical MRI, T1- (a), T2- (b) and contrast enhanced T1-weighted images (c) show a paraganglioma (arrows) with typical ‘salt and pepper’ aspect and enhancement after gadolinium injection, surrounding the right internal carotid artery (arrowheads). MR angiography (d) demonstrates a hypervascular tumor very close to the body of the right internal carotid artery (ICA) (black arrow).
1. Headache Classification Committee of the International Headache Society. The International Classification of Headache Disorders, 3rd ed. (beta). Cephalalgia 2013; 33(9): 629–808. 2. Candeloro E, Canavero I, Maurelli M, et al. Carotid dissection mimicking a new attack of cluster headache. J Headache Pain 2013; 14: 84. 3. Godeiro-Junior C, Kuster GW, Felı´ cio AC, et al. Internal carotid artery dissection presenting as cluster headache. Arq Neuropsiquiatr 2008; 66(3-B): 763–764.
1 Service de Neurologie, CHU Montpellier, Hoˆpital Gui de Chauliac, France 2 Service de Neuroradiologie, CHU Montpellier, Hoˆpital Gui de Chauliac, France
Corresponding author: Clarisse Carra-Dalliere, Service de Neurologie, CHU Montpellier, Hoˆpital Gui de Chauliac, 80 Avenue Augustin Fliche, 34295 Montpellier Cedex 5, France. Email: [email protected]
Carotid paraganglioma mimicking a cluster headache
Cephalalgia 2014, Vol. 34(13) 1111 ! International Headache Society 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/0333102414530523 cep.sagepub.com
Pauline Malissart1, Anne Ducros1, Pierre Labauge1, Nicolas Menjot De Champfleur2 and Clarisse Carra-Dalliere1
A 60-year-old woman presented a 3 day-history of severe recurrent right periorbital pain, with ipsilateral conjunctival injection and lacrimation, lasting 20 minutes, occurring five times a day. Those features satisfied criteria A to D of cluster headaches (CH) of the International Classification of Headache Disorders (1). Criterion E implies the exclusion of symptomatic etiologies, thus cerebral and cervical MRI imaging was performed, revealing a voluminous ipsilateral carotid paraganglioma (Figure 1). After a complete resection of the paraganglioma, CH was resolved. Several etiologies of secondary CH have already been described, mainly carotid dissections (2,3). Carotid paraganglioma should be added to the list. Conflict of interest None declared.
References Figure 1. Axial cervical MRI, T1- (a), T2- (b) and contrast enhanced T1-weighted images (c) show a paraganglioma (arrows) with typical ‘salt and pepper’ aspect and enhancement after gadolinium injection, surrounding the right internal carotid artery (arrowheads). MR angiography (d) demonstrates a hypervascular tumor very close to the body of the right internal carotid artery (ICA) (black arrow).
1. Headache Classification Committee of the International Headache Society. The International Classification of Headache Disorders, 3rd ed. (beta). Cephalalgia 2013; 33(9): 629–808. 2. Candeloro E, Canavero I, Maurelli M, et al. Carotid dissection mimicking a new attack of cluster headache. J Headache Pain 2013; 14: 84. 3. Godeiro-Junior C, Kuster GW, Felı´ cio AC, et al. Internal carotid artery dissection presenting as cluster headache. Arq Neuropsiquiatr 2008; 66(3-B): 763–764.
1 Service de Neurologie, CHU Montpellier, Hoˆpital Gui de Chauliac, France 2 Service de Neuroradiologie, CHU Montpellier, Hoˆpital Gui de Chauliac, France
Corresponding author: Clarisse Carra-Dalliere, Service de Neurologie, CHU Montpellier, Hoˆpital Gui de Chauliac, 80 Avenue Augustin Fliche, 34295 Montpellier Cedex 5, France. Email: [email protected]
