Systematic Reviews
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. May 16, 2021; 9(14): 3294-3307
Published online May 16, 2021. doi: 10.12998/wjcc.v9.i14.3294
Cluster headache due to structural lesions: A systematic review of published cases
Ru-Jin Long, You-Sheng Zhu, An-Ping Wang
Ru-Jin Long, You-Sheng Zhu, An-Ping Wang, Emergency Medicine Center, The First Affiliated Hospital of University of Science and Technology of China, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230000, Anhui Province, China
Author contributions: Long RJ conceived and designed the study; Long RJ and Wang AP collected the data and collated the statistics; Long RJ wrote the paper; Zhu YS and Wang AP reviewed and edited the manuscript; All authors read and approved the manuscript.
Conflict-of-interest statement: There is no conflicts of interest or competing interests in this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ru-Jin Long, MD, Doctor, Emergency Medicine Center, The First Affiliated Hospital of University of Science and Technology of China, Division of Life Sciences and Medicine, University of Science and Technology of China, No. 17 Lujiang Street, Luyang District, Hefei 230000, Anhui Province, China. longrujin1992@163.com
Received: September 19, 2020
Peer-review started: September 19, 2020
First decision: January 7, 2021
Revised: January 21, 2021
Accepted: March 24, 2021
Article in press: March 24, 2021
Published online: May 16, 2021
ARTICLE HIGHLIGHTS
Research background

Among the primary headaches, cluster headache (CH) presents very particular features allowing a relatively easy diagnosis based on criteria listed in Chapter 3 of the International Classification of Headache Disorders. However, as in all primary headaches, possible underlying causal conditions must be excluded to rule out a secondary cluster-like headache (CLH).

Research motivation

The review aims to contribute to the knowledge on CLH caused by structural lesions and to provide better guides in the distinguishing process.

Research objectives

We analysed the published cases of symptomatic CH and CLH in PubMed and Google Scholar databases.

Research methods

We conducted a systematic review of published cases of symptomatic CH and CLH and analysed the features of the patients.

Research results

Structural pathologies associated with CH were vascular (37.7%), tumoural (32.5%) and inflammatory (27.2%). Patients with atypical clinical features require careful evaluation for structural origins. CLH patients may be responsive to typical CH treatments; the treatment response is not specific. CLH can be triggered by contralateral structural pathologies. CLH-associated sinusitis and cerebral venous thrombosis are worth paying attention to.

Research conclusions

Secondary headaches could perfectly mimick primary CH, hence neuroimaging should be conducted in patients in whom primary and secondary headaches are suspected. Cerebral magnetic resonance imaging scans are the diagnostic management of choice, and further examinations include vessel imaging with contrast agents and dedicated scans focusing on specific cerebral areas (sinuses, ocular and sellar regions). Neuroimaging is as necessary at follow-up visits as at the first observation.

Research perspectives

We investigated the clinical features of CLH patients in published cases and tried to summarize their distinctive characteristics by comparing to patients with primary CH.