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Topic: FR - Cluster Impersonators (Read 700 times) |
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floridian
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This article says that on rare occasions, damage to the carotid artery can mimick cluster headache. I'm not sure that it isn't actually a cluster headache being triggered by an interupted blood flow - I guess the point is that sometimes a MRI or CAT scan can turn up problems that need to be fixed. That, or we really need to guard against the cluster wannabees.
Quote:Headache. 2005 Jan;45(1):84-86.
Peripheral Postganglionic Sympathicoplegia Mimicking Cluster Headache Attacks.
Hannerz J, Arnardottir S, Bro Skejo HP, Lilja JA, Ericson K.
After dissection with complete occlusion of the internal carotid artery, a 58-year-old man started to suffer from intense cluster headache-like attacks. Magnetic imaging showed signs of nonsymptomatic cerebral emboli, which could be dated to have occurred in temporal relation to the start of the attacks, all on the right side. This case and two similar ones indicate that peripheral postganglionic sympathicoplegia can cause attacks with similar pain characteristics, accompanying symptoms, duration, and regularity as in cluster headache. |
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Bob_Johnson
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FR - Cluster Impersonators
« Reply #1 on: Jan 25th, 2005, 9:06am » |
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Rather like this report:
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Title: "Cluster Headache Mimics"--useful article. Post by Bob_Johnson on Jul 30th, 2004, 2:04pm
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This is an important article to obtain and take to your doctor if you are having a difficult time getting a diagnosis of the type of headache problem you have and/or finding medications which give consistent relief for cluster. It is a technically difficult read for someone not educated in medicine. Its value is in providing case studies about uncommon conditions which appear to be cluster headache but which are, in fact, not.
Broad signs which may signal that the problem being treated is a cluster mimic are: having made a diagnosis of cluster, the standard medications do not work OR they work for an episode or two and then stop being effective. Second, if the diagnostic signs differ in important ways from the standard signs for cluster (and this is a subtle issue which requires a physician with sophistication).
One of the striking findings reported: Cluster can arise from head trauma as long as 30-years after the trauma!
Some conditions which can mimic primary cluster headache:
Infections
Aspergillus
Inflammatory disorders
Wegener's granulomatosis
Orbital myositis
Plasmacytoma
Multiple sclerosis
Head trauma
Vascular abnormalities
Arterial dissections
Arteriovenous malformations
Neoplasms
Pituitary tumors
Metastases
Other trigeminal autonomic cephalgias: SUNCT syndrome; Paroxysmal hemacrania; Hypnic headache
"Cluster Headache Mimics", Dale M. Carter, M.D.. CURRENT PAIN AND HEADACHE REPORTS, 2004, 8:133-139.
(Take this citation to your public library and they can order a copy of the complete article for you.)
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Bob Johnson
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Biker
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Re: FR - Cluster Impersonators
« Reply #2 on: Jan 25th, 2005, 3:45pm » |
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I think it would be a wonderfull thing if I found I was a CH wannabe. Vascular abnormalities after head trauma? I wish I could be "cured" of my headaches for life. How are the doctors gonna fiugre that one out? Where shall I go to get a deep insight to this delimia? I do not believe anyone who has this kind of pain is a wannabe. I personally, deeply consider the dark beyond, every summer during cycle.
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floridian
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Re: FR - Cluster Impersonators
« Reply #3 on: Jan 25th, 2005, 4:50pm » |
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Ok, Biker, I was not serious ... there are no cluster wannabees - why would anyone want such pain?? Makes no sense ... Oh ... wait ... irony! A joke of sorts. I don't think the pain itself is funny, but having lived with it for years, some humor seeps in around the edges. More of a grin and bear it, while we try to deal with it via medicine.
Just trying to digest and present the latest in research - your right, it would be nice if everyone had an easily fixed vascular problem that would reduce their cluster burden. Clusterheads and migraineurs do tend to clot too much, which may cause microvascular problems. I can think of three bona fide clusterheads that improved after treating vascular conditions.
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| « Last Edit: Jan 25th, 2005, 4:54pm by floridian » |
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Gator
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Re: FR - Cluster Impersonators
« Reply #4 on: Jan 26th, 2005, 1:39am » |
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peripheral postganglionic sympathicoplegia
Why can't our disorder have a cool name like this.
What's wrong with you. Cluster Headache. Headache? Oh, there is aspirin in the (((SPLAT)))  Damn. I lose more partners this way. 
I can see how a person could think they have ch if they have a disease that mimics it's symptoms. What I don't understand why someone would out and out pretend they have CH. It's not exactly the glamorous/scary/ tropical disease one thinks of when trying to get the attention/sympathy of any particular group of people.
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Marc
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Re: FR - Cluster Impersonators
« Reply #5 on: Jan 26th, 2005, 12:22pm » |
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Good topic -
This is why having an MRA is a good idea to rule out vascular abnormalities, in addition to an MRI.
I know of a case where the MRI looked good, but the MRA clearly showed blockage and dissention of the carotid. Surgery wiped out the headaches and eliminated a possible life threatening condition.
Marc
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BarbaraD
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Re: FR - Cluster Impersonators
« Reply #6 on: Jan 26th, 2005, 3:11pm » |
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Can someone tell me where to find these articles? I'm in the middle of researching causes and related stuff for a lawsuit. Need all the help I can get.
Hugs BD
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JJA
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Re: FR - Cluster Impersonators
« Reply #7 on: Jan 26th, 2005, 3:27pm » |
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Does anyone know if these "wannabes" respond to the same meds as CH-classic?
Also when it says: Quote:| characteristics, accompanying symptoms, duration, and regularity as in cluster headache |
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Does that also include episodic-like remission? If it looks like a duck and it quacks like a duck...
Jesse
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floridian
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Re: FR - Cluster Impersonators
« Reply #8 on: Jan 26th, 2005, 3:33pm » |
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on Jan 26th, 2005, 3:11pm, BarbaraD wrote:Can someone tell me where to find these articles? I'm in the middle of researching causes and related stuff for a lawsuit. Need all the help I can get.
Hugs BD |
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http://www.ncbi.nlm.nih.gov/entrez/query.fcgi will get you the citations and often the abstracts. Usually, to get the full article, you need to go to a university that subscribes to the journal or order online ($25 is a common price for one article!) Occasionally, the full text is free online, but this is not so common.
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sandie99
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Re: FR - Cluster Impersonators
« Reply #9 on: Jan 26th, 2005, 3:48pm » |
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CH wannabes.... chey, everything has few of those, then...
But interesting article. Thanks for sharing it!
PFdays wishes real clusterhead
Sandie
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CH happends, Live anyway! PF days to us all!
"Do what you can and let God take care of the rest. Leave your heart wide open and always wish for the best" (Sanna Hillu)
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BarbaraD
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Re: FR - Cluster Impersonators
« Reply #10 on: Jan 26th, 2005, 8:47pm » |
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Thanks -- now I've got some reading to do. Oh joy... 
Thanks again....
Hugs BD
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JJA
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Re: FR - Cluster Impersonators
« Reply #11 on: Jan 27th, 2005, 8:54am » |
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on Jan 26th, 2005, 3:27pm, JJA wrote:Does anyone know if these "wannabes" respond to the same meds as CH-classic?
Also when it says:
Does that also include episodic-like remission? |
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OK, I'll answer my own question. After a few hours of researching this, I could find no evidence that this could behave in an episodic manner. All case reports were either a few months of attacks, never to return (with or without surgery) or a more chronic CH type of pattern.
Also interesting... These do not seem to be cluster-like attacks. They ARE cluster attacks brought on by carotid artery problems instead of our hypothalamic/whatever-the-hell-else malfunction. The MD's theorize (note: they have no evidence to support this, it's pure speculation) that lack of blood flow to the brain due to carotid occlusion, triggers increased blood flow in adjacent areas (hence vasodilatation). Presto, CH attack.
More simply, due to lack of blood flow, the brain says, "Give me more blood," to the point of a CH attack.
They also get in to explaning why it would be clock-like, but I'm sure no one read this far into this post anyway.
Hey Barbara D, I have decent access to electronic versions. If you want a full text article PM me before you drop $25.
Jesse
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floridian
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Re: FR - Cluster Impersonators
« Reply #12 on: Jan 27th, 2005, 9:05am » |
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on Jan 27th, 2005, 8:54am, JJA wrote:
... These do not seem to be cluster-like attacks. They ARE cluster attacks brought on by carotid artery problems instead of our hypothalamic/whatever-the-hell-else malfunction. The MD's theorize (note: they have no evidence to support this, it's pure speculation) that lack of blood flow to the brain due to carotid occlusion, triggers increased blood flow in adjacent areas (hence vasodilatation). Presto, CH attack.
More simply, due to lack of blood flow, the brain says, "Give me more blood," to the point of a CH attack.
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Aha - I suspected that, but wasn't sure. That theory makes sense and ties in with the facts that oxygen aborts, apnea is common, anti-coagulants can prevent, etc etc.
The fact that many people with a carotid problem or apnea do not get clusters indicates that other things needed, but the pieces are falling into place.
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| « Last Edit: Jan 27th, 2005, 9:06am by floridian » |
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Gator
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Re: FR - Cluster Impersonators
« Reply #13 on: Jan 28th, 2005, 12:11am » |
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on Jan 27th, 2005, 8:54am, JJA wrote:| They also get in to explaning why it would be clock-like, but I'm sure no one read this far into this post anyway. |
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So down. Of course we read this far into your post. This is just more proof of what Marc was saying about an MRA being as necessary as an MRI.
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Mr. Happy
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Re: FR - Cluster Impersonators
« Reply #14 on: Jan 28th, 2005, 2:08am » |
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OK......so if CH is prevelant in oh.....say....0.1% of the population, what percentage have defective vascular plumbing?
All this Fact stuff intrigues me,
RJ
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JJA
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Re: FR - Cluster Impersonators
« Reply #15 on: Jan 28th, 2005, 9:51am » |
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on Jan 28th, 2005, 2:08am, Mr. Happy wrote:OK......so if CH is prevelant in oh.....say....0.1% of the population, what percentage have defective vascular plumbing?
All this Fact stuff intrigues me,
RJ |
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You mean what percentage of that 0.1%??? I don't think there's any statistics on this, but I would guess, a lot, but not that many...  What I mean is, we all have some vascular issues, especially as we age. On the other hand, this report is about a man with complete occlusion of the carotid artery (he had a stroke). If your plumbing's in that condition, either you make some changes fast or you die. If a lot of us were in that conditon, we'd be dropping like flies with strokes and heart attacks. (We do seem to be at increased risks for this) Just my thoughts, no research to support it...
Jesse
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floridian
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Re: FR - Cluster Impersonators
« Reply #16 on: Jan 28th, 2005, 11:39am » |
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on Jan 28th, 2005, 2:08am, Mr. Happy wrote:OK......so if CH is prevelant in oh.....say....0.1% of the population, what percentage have defective vascular plumbing?
All this Fact stuff intrigues me,
RJ |
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Yeah, the percent of the population is fairly high that has some vascular problem. I don't see a particular vascular problem as required for CH, it just raises the risk. The PFO heart problem is fairly common in the general population - twice as common in clusterheads, and less than half of us have that. But having a PFO hole in the heart seems to increase the risk that you get clusters. It takes something else, or some combination of factors.
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