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Intolerance to smell is often reported by migraine patients. This study evaluates osmophobia in connection with the diagnosis of migraine and episodic tension-type headache (ETTH). The characteristics of this symptom are also investigated. We recruited from our Headache Centre 1005 patients (772 female, 233 male; age 37 ± 11 years), of whom 677 were migraine without aura (MoA), 130 migraine with aura (MA) and 198 TTH. Patients with two or more forms of primary headache were excluded. Among migraine patients, 43.9% with MoA and 38.5% with MA reported osmophobia during the attacks; none of the 198 TTH patients suffered this symptom. Most frequently offending odours were scents (63.9%), food (55.2%) and cigarette smoke (54.8%). Osmophobia appears structurally integrated into the migraine history of the patient. It seems to be a peculiar symptom favouring the diagnosis of migraine (MoA and MA) in the differential diagnosis with ETTH. [ABSTRACT FROM AUTHOR]

Presents a letter to the editor published in the periodical "Cephalalgia," discussing intermittent angle-closure glaucoma in the presence of a white eye, posing as retinal migraine.

The article presents the case of a 27-year-old diagnosed with superior oblique myokymia (SOM). The patient had no history of migraine or headache before the development of SOM. Meanwhile, the presentation of migraine attacks never developed during the night, and was consequent to the worsening of SOM. As a result, the physicians attended the case found tenderness on local examination of the right trochlear region that was not usually found in SOM .

Discusses the effect of warfarin therapy on the occurrence of Cluster-like headache (CH) in a patient. Frequent causes of CH; Symptoms of the attack suffered by a patient after the warfarin therapy; Duration of the headache caused due to warfarin therapy.

A case of carotid artery dissection in a 41-year-old-woman is described whose main symptom was cluster-like pain. The case is interesting for its atypical presentation with only two other like cases in the literature, and the site of dissection, localized in the intrapetrous curvature of the carotid artery. The case highlights the need for active co-operation between clinician and neuroradiologist during neuroimaging assessment which must be focused on the clinical evaluation of the individual patient so as to avoid error, particularly in atypical cases. [ABSTRACT FROM AUTHOR]

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 (ICHD-II). However, as in all primary headaches, possible underlying causal conditions must be excluded to rule out a secondary cluster-like headache (CLH). The observation of some cases with clinical features mimicking primary CH, but of secondary origin, led us to perform an extended review of CLH reports in the literature. We identified 156 CLH cases published from 1975 to 2008. The more frequent pathologies in association with CLH were the vascular ones (38.5%, n¼ 57), followed by tumours (25.7%, n¼ 38) and inflammatory infectious diseases (13.5%, n¼ 20). Eighty were excluded from further analysis, because of inadequate information. The remaining 76 were divided into two groups: those that satisfied the ICHD-II diagnostic criteria for CH, ‘fulfilling’ group (F), n¼ 38; and those with a symptomatology in disagreement with one or more ICHD-II criteria, ‘not fulfilling’ group (NF), n¼ 38. Among the aims of this study was the possible identification of clinical features leading to the suspicion of a symptomatic origin. In the differential diagnosis with CH, red flags resulted both for F and NF, older age at onset; for NF, abnormal neurological/general examination (73.6%), duration (34.2%), frequency (15.8%) and localization (10.5%) of the attacks. We stress the fact that, on first observation, 50% of CLH presented as F cases, perfectly mimicking CH. Therefore, the importance of accurate, clinical evaluation and of neuroimaging cannot be overestimated. [ABSTRACT FROM AUTHOR]

Presents abstracts of several studies on cluster headache. 'Cluster headache without pain,' by I. Pavao-Martins, R. Gil-Gouveia and J. Joao-Lobo-Antunes; 'Hemicrania continua with contralateral episodic cluster headache: a case report,' by C. Lisotto, F. Dainese and F. Maggioni; 'Pain-relieving measures and behaviour during cluster headache attacks,' by E.P. Parreira, A. Tome, R.G. Gouveia and I.P. Martins.

Discusses the case of a female patient with cluster-like headache completely fulfilling the International Headache Society diagnostic criteria. Patient's history of daily headache; Findings of computed tomography and magnetic resonance imaging scans; Autonomic symptoms observed in the patient due to the activation of trigeminal vascular and cranial parasympathetic pathways.

Describes a case of remitting hemicrania continua (HC) with absolute response to indomethacin evolving from migraine with aura. Continuous unilateral headache of fluctuating intensity; Exacerbations of more severe pain; Autonomic disturbances; Conjunctival injection; Lacrimation; Nasal congestion; Rhinorrhoea.