open access

Vol 47, No 4 (2013)
OPIS PRZYPADKU
Submitted: 2012-05-09
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Nummular headache after trans-sphenoidal surgery: a referred pain-based headache syndrome

Hsin-Ling Yin, Chi Chui, Wai-Fai Tung, Wei-Hsi Chen
DOI: 10.5114/ninp.2013.36764
·
Neurol Neurochir Pol 2013;47(4):398-401.

open access

Vol 47, No 4 (2013)
OPIS PRZYPADKU
Submitted: 2012-05-09

Abstract

Nummular headache (NH) is a newly categorized primary headache characterized by a consistent location, shape and size of painful area in each attack. The etiopathogenesis is entirely unknown. Currently, the peripheral theory of epicranial neuralgia is accepted more widely than the central theory but it cannot fully explain the clinical picture.

We report a patient who suffered from a relapsing and remitting course of NH at the high parietal area and vertex shortly after resection for pituitary prolactinoma via a trans-sphenoidal approach. There was no focal trophic change or paresthesia but a mild allodynia in the painful area. The patient did not exhibit trigeminal sensory disorder or cranial trauma thoroughly. The pain responded well to gabapentin. Therefore, physicians should be aware of postoperative NH, which is amenable to treatment. The findings in our patient support a dual mechanism of NH and suggest that central NH is a form of referred pain.

Abstract

Nummular headache (NH) is a newly categorized primary headache characterized by a consistent location, shape and size of painful area in each attack. The etiopathogenesis is entirely unknown. Currently, the peripheral theory of epicranial neuralgia is accepted more widely than the central theory but it cannot fully explain the clinical picture.

We report a patient who suffered from a relapsing and remitting course of NH at the high parietal area and vertex shortly after resection for pituitary prolactinoma via a trans-sphenoidal approach. There was no focal trophic change or paresthesia but a mild allodynia in the painful area. The patient did not exhibit trigeminal sensory disorder or cranial trauma thoroughly. The pain responded well to gabapentin. Therefore, physicians should be aware of postoperative NH, which is amenable to treatment. The findings in our patient support a dual mechanism of NH and suggest that central NH is a form of referred pain.

Get Citation

Keywords

nummular headache, postoperative headache, prolactinoma, trans-sphenoidal surgery

About this article
Title

Nummular headache after trans-sphenoidal surgery: a referred pain-based headache syndrome

Journal

Neurologia i Neurochirurgia Polska

Issue

Vol 47, No 4 (2013)

Pages

398-401

DOI

10.5114/ninp.2013.36764

Bibliographic record

Neurol Neurochir Pol 2013;47(4):398-401.

Keywords

nummular headache
postoperative headache
prolactinoma
trans-sphenoidal surgery

Authors

Hsin-Ling Yin
Chi Chui
Wai-Fai Tung
Wei-Hsi Chen

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