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Laughing Headache With Giant Pacchionian Granulations


Address all correspondence to P. Giraud, Service de Neurologie, Consultation Céphalées et Migraine Pole Médecine Interne, Centre Hospitalier de la Région d'Annecy, 1 avenue de l'Hôpital, BP 90074, 74374 Pringy Cedex, France, email:


Laughing is recognized as a provoking factor for headache, certainly underestimated among the general population and few cases have been published to date. We report a single case of severe headache, provoked almost exclusively by outbursts of laughing, where venous magnetic resonance imaging revealed the presence of giant Pacchioni granulations in both right and transverse sinuses. Reviewing published cases of laughing headache, we discuss possible mechanisms of pain and the role of giant Pacchionian granulations.