Nummular headache related to structural lesions

Background: Nummular headache or coin-shaped cephalgia characterized by mild-to moderate pressure-like pain felt in a rounded or alliptical area typically 2-6 cm in diameter usually in the parietal area. The pain remains confined to the same symptomatic area which does not change in shape or size with time. The pain is continuous but lancinating exacerbations for several seconds may superimpose the baseline pain. The affected area may show paresthesia or tenderness. Case I: Trigeminal Neuralgia Evolving into Nummular Headache. A 66-year-old man with acutely developed a sharp, intermittent, retro-orbital pain, there was no sign of autonomic dysfunction, neurologic examination was normal, and brain MRI was normal after 12 days he described a mild to moderate constant pain, but also an intermittent lancinating pain in left eye, original excruciating pain disappeared and now his headache was a 2 cm circular area located behind to his left ear. Case II: Nummular Headache and Pituitary Lesion. A 54-year-old woman since 1 year ago, she suffered a cyclic recurrence of headache. The pain was mild to moderate in intensity, lancinating or electric in nature, exclusively, located at vertex and left parasagital area, circular in shape, 3.0 cm×3.0 cm in size. Brain MRI revealed a huge mass at supra sella region trans-sphenoidal microsurgery was performed, pathological study revealed adenoma cells. Conclusion: Nummular headache can be a referred pain from intracranial secondary involving the nearby pain-sensitive structures.

Nummular headache related to structural lesions Keywords:

headache , headache