Ranieri A; Topa A; Cavaliere M; De Simone R
The co-occurrence of epistaxis and cephalalgia is not aberrant in cephalalgia patients, although alone few case letters accept been published. A trigeminovascular activation may be causally complex although the exact mechanisms bond epistaxis and cephalalgia abide unclear. Cogent dural atrium binding may sustain or aggravate an added bookish venous burden and is advised a radiological augur of idiopathic intracranial hypertension. We address a 49-year-old changeable accommodating with abiding cephalalgia associated to cutting headache-like attacks followed by epistaxis and by the resolution or the cogent advance of pain. As she additionally appear accessory affection evocative of aloft intracranial burden and showed a mutual absorption of axle sinuses at MR-venography, a accessible intracranial hypertension was accepted admitting the abridgement of papilledema. Acetazolamide 250 mg twice/day was added to analysis and the accommodating appear abrupt abridgement of cephalalgia severity and abundance and complete resolution of both the cutting affliction and the alternate epistaxis, maintained for 5 months. At analysis cessation she complained the deepening of cephalalgia cephalalgia and the alliteration of the superimposed cutting affliction followed by epistaxis. The apparatus bond the consecutive accident of aching stabs, epistaxis and abatement from affliction with aloft intracranial burden in our patients charcoal unclear. We brainstorm that the abrupt reopening of burst accessory veins of the antecedent venous circle, possibly prompted by alternate after-effects of axial venous hypertension accompanying with intracranial hypertensive peaks, could explain the abnormal austere time assumption of aching stabs, epistaxis, and consecutive resolution of pain.
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.
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