Two symptomatic cases of cluster headache associated with internal carotid artery dissection

Abstract

Cluster headache is a clinical entity characterised by strictly unilateral head pain attacks accompanied by ipsilateral autonomic phenomena. We report two patients who had pain episodes mimicking cluster headache attacks, and who experienced a total or partial Horner's syndrome ipsilaterally to pain, persisting for 48 h after the last attack. A dissection of the ipsilateral internal carotid artery at the extra–intracranial passage was present in both cases. These cases highlight the need for extensive neuroradiological investigation in cluster headache patients when atypical features are present.