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Sammanfattning

Cluster headache is a primary headache by definition not caused by any known underlying structural pathology. However, symptomatic cases have been described, e.g. tumours, dissections and infections. In many cases it is difficult to establish a causal relationship between the headache and the underlying pathology. The proper evaluation of cluster headache is an issue unresolved. The literature has been reviewed for symptomatic cluster headache or cluster headache-like cases in which causality was likely. The review also attempts to identify clinical predictors of underlying lesions in order to formulate guidelines for neuroimaging. Even typical cluster headaches can be caused by structural lesions and the response to typical cluster headache treatments does not exclude a secon­d­ary form. Neuroimaging, preferably contrast-enhanced magnetic resonance imaging and magnetic resonance angiography, should be undertaken in patients with atypical symptomatology, late onset, abnormal examination (including Horner’s syndrome), or those re­sistant to the appropriate medical treatment. The decision to perform magnetic resonance imaging in cases of typical cluster headache remains a matter of medical art.

MeSH