[Triptan-responsive migraine-like headache caused by cavernous sinus dural arteriovenous fistula in a 69-year-old woman with a history of migraine without aura].

Abstract

A 69-year-old woman with a previous history of migraine without aura developed throbbing headache in the right frontal region accompanied by nausea, lasting more than 4 hours a day. The headache intensity was more severe than that of usual her migraine headaches. Administration of eletriptan in the previous hospital improved her headaches. However, one month later the patient experienced more intense headaches in the same region and then was referred to our hospital. MR angiography showed abnormal signal intensities in the cavernous sinus. Cerebral angiography revealed blood reflux to the cavernous sinus, leading to diagnosis of cavernous sinus dural arteriovenous fistula. Transvenous embolization of cavernous sinus dural arteriovenous fistula was performed, which resulted in resolution of the patient's headache. We should be aware that patients with cavernous sinus dural arteriovenous fistula can manifest migraine-like headaches without being accompanied by cranial nerve palsies.

• Authors: Mika Saiki, Keisuke Suzuki, Hidehiro Takekawa, Hideaki Kanaya, Shunsuke Kawamoto, Toshiki Nakamura, Koichi Hirata
• Journal: Rinsho shinkeigaku = Clinical neurology (Rinsho Shinkeigaku) Vol. 58 Issue 3 Pg. 188-192 (Mar 28 2018) ISSN: 1882-0654 [Electronic] Japan
• PMID: 29491334 (Publication Type: Case Reports, Journal Article, Review)

Chemical References

• Tryptamines

Topics

• Aged
• Cavernous Sinus (abnormalities, diagnostic imaging)
• Central Nervous System Vascular Malformations (complications, diagnostic imaging, therapy)
• Cerebral Angiography
• Embolization, Therapeutic (methods)
• Female
• Humans
• Magnetic Resonance Angiography
• Migraine Disorders (drug therapy, etiology)
• Migraine with Aura (complications)
• Treatment Outcome
• Tryptamines (administration & dosage)