From the Department of Neurosurgery, Kochi University School of Medicine, Kohasu, Okoh-cho, Nankoku-City, Japan.
A Migraine-Like Headache Induced by Carotid-Cavernous Fistula
Article first published online: 13 FEB 2007
Headache: The Journal of Head and Face Pain
Volume 47, Issue 2, pages 289–293, February 2007
How to Cite
Yamada, S. M., Masahira, N. and Shimizu, K. (2007), A Migraine-Like Headache Induced by Carotid-Cavernous Fistula. Headache: The Journal of Head and Face Pain, 47: 289–293. doi: 10.1111/j.1526-4610.2006.00698.x
- Issue published online: 13 FEB 2007
- Article first published online: 13 FEB 2007
- Accepted for publication October 18, 2006.
- carotid-cavernous fistula;
- endovascular embolization;
Carotid-cavernous fistula (CCF) generally causes periorbital aching with ocular symptoms due to high venous pressure in the cavernous sinus, while migraine is caused by arterial dilatation-stimulating trigeminal nerves around the vessels. The authors present a case of 47-year-old woman with a 4-month history of a temporal throbbing headache. As her symptoms were well controlled by triptans, her headache was considered to be migraine in type. However, a Barrow's type-D CCF was revealed by radiological examinations. Self-compression of common carotid artery method was initially tried for therapy of the CCF, but endovascular embolization was finally necessary due to intractable headache. Although the headache was considered arterial in origin, transvenous embolization of the left cavernous sinus successfully ameliorated the patient's symptoms. CCF should be considered as an unusual etiology of headaches that appear arterial in origin.