Superficial Artery Aneurysms Underlying Nummular Headache – 2 Cases and Proposed Diagnostic Work-Up


  • Conflict of Interest: None.
  • None of the authors received financial support. Informed consent was obtained from the patients included in this case report.



Nummular headache, considered a primary headache in the 3rd edition of the InternationalClassification ofHeadacheDisorders, has nonetheless been attributed in several occasions to underlying epicranial anomalies.

Case reports

Vascular imaging of the head in 2 patients with nummular headache revealed fusiform aneurysms of the scalp vessel in close relation to the painful area. One of the patients underwent surgical resection of the aneurysm with excellent response. A response to triptans was noted in both.


In selected patients with nummular headache, vascular imaging of the scalp may reveal anomalies amenable to surgical treatment or triptan administration, sometimes resulting in disappearance of the pain.