Symptomatic cluster headache - clinical presentation, diagnostics and possible pathogenesis

Abstract

Cluster headache is an idiopathic headache disorder with a characteristic semiology and a typical temporal pattern. However, there are several case reports describing the development of cluster headache after head trauma or in combination with a non-traumatic structural disease of the head. The clinical presentation of these cases is very similar to that of idiopathic cluster headache, although the majority develops chronic cluster headache. The close temporal association between the beginning or the end of cluster headache attacks and the development or effective treatment of a lesion provides strong evidence that structural diseases may play a causal role in the pathogenesis of cluster headache. The irritation of sensory and nociceptive afferents caused by a trauma or a non-traumatic lesion might lead to reorganizotional changes in the trigeminal system and in the hypothalamus and, therefore, participate in the development of symptomatic cluster headache.