神経学的障害

Headache in a Patient with an Extracranial Lipoma: Report of a New Case

Abstract

Escuti N

Lipomas are very common benign tumors; however, only four cases of headaches caused by extracranial lipomas have been reported. Moreover, the headache phenotypes and clinical course have been poorly described. Herein, we describe a case of 50 year-old-man who developed new onset predominately right-sided frontotemporal cluster-like headache since age 48. In 2005, he had generalized headaches that improved after a resection of an occipital lipoma. Imaging showed regrowth of the lipoma at the C1-C2 spinal level. Treatment with Excedrin tabs and sumatriptan injections helped within 20 minutes. His symptoms were worse in the summer and spring. He spontaneously improved after a few months. We review cases of lipoma-induced headaches in the literature, several of which resemble a trigeminal autonomic cephalalgias and are associated with compression of trigeminal or cervical peripheral nociceptors. This case offers the opportunity to discuss the possible pathophysiological mechanisms underlying cluster-like headaches symptoms and the relation with pain referral from cervical structures to the head.