Enucleation and development of cluster headache: a retrospective study

Abstract

Background: Cluster headache (CH) is a neurovascular, primary headache disorder. There are, however, several case reports about patients whose CH started shortly after a structural brain disease or trauma. Motivated by a patient who developed CH 3 weeks after the removal of an eye and by similar case reports, we tested the hypothesis that the removal of an eye is a risk factor for CH.

Methods: A detailed headache questionnaire was filled out by 112 patients on average 8 years after enucleation or evisceration of an eye.

Results: While 21 % of these patients experienced previously unknown headaches after the removal of an eye, no patient fulfilled the diagnostic criteria for CH.

Conclusion: Our data does not suggest that the removal of an eye is a major risk factor for the development of CH.

Figure 1

Pain in cluster headache. The location of intense pain, usually orbital or supraorbital, in a CH attack, overlayed onto the portrait of Franz Kafka (1924). Kafka suffered from extremely severe headache attacks, possibly CH [39].

Figure 2

Orbital anatomy. High-resolution axial T1-weighted native MRI of a volunteer without structural abnormalities at 3.0 Tesla. Structures removed during enucleation (globe, part of the optic nerve, insertions of the external eye muscles) are highlighted by the red ellipse.