Hemicrania Continua-Like Headache Associated With Internal Carotid Artery Dissection May Respond to Indomethacin


  • Avi Ashkenazi MD,

  • Muhammad A. Abbas MD,

  • Dinesh K. Sharma MD,

  • Stephen D. Silberstein MD, FACP

  • From the Department of Neurology, Thomas Jefferson University Hospital, Philadelphia, PA (Drs. Ashkenazi, Abbas, Silberstein); Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, PA (Dr. Sharma).

Address all correspondence to Avi Ashkenazi, Jefferson Headache Center, 111 S. 11th Street, STE 8130, Philadelphia, PA 19107.


Hemicrania continua (HC) is an idiopathic, chronic disorder characterized by a continuous, strictly unilateral headache associated with ipsilateral cranial autonomic symptoms. The symptoms of HC typically respond dramatically to indomethacin therapy. We describe a patient with traumatic internal carotid artery dissection, who presented with a clinical picture mimicking HC that initially responded to indomethacin. Patients with a clinical picture similar to HC should be managed with a high index of suspicion for a possible cervical arterial dissection.