A Hemicranial headache, most commonly referring to Hemicrania Continua, is a rare, persistent, one-sided headache with constant moderate pain, punctuated by severe, stabbing attacks, accompanied by autonomic symptoms like tearing or nasal congestion on the affected side, and uniquely responsive to indomethacin treatment. It's a primary headache, meaning it's not caused by another condition, and is part of a group called Trigeminal Autonomic Cephalalgias (TACs).
Healthcare providers don't know what causes hemicrania continua. It isn't caused by an underlying medical condition. Research suggests hemicrania continua may involve: Inflammation in your cavernous sinus (an area in your brain that protects certain blood vessels, nerves and your pituitary gland)
The most effective treatment for hemicrania continua is indomethacin which is also used for the diagnosis. However, not everyone can tolerate indomethacin on a daily basis and other treatments can be useful. There is currently no cure for hemicrania continua and preventive treatments are used to control the symptoms.
Differential diagnosis
Up to 71% of patients with hemicrania continua fulfil the diagnostic criteria for migraine during exacerbations, and migraine is the most common misdiagnosed condition for hemicrania continua (71).
Paroxysmal hemicrania is a rare form of headache that usually begins in adulthood. Patients experience severe throbbing, claw-like, or boring pain usually on one side of the face; in, around, or behind the eye; and occasionally reaching to the back of the neck.
Hemicrania continua is a primary headache disorder characterized by a persistent and severe pain that is felt on one side of your head.
If left untreated or poorly managed, Hemicrania Continua can lead to several complications, including: Chronic Pain: Persistent headaches can result in chronic pain syndromes. Medication Overuse Headache: Frequent use of pain medications can lead to rebound headaches.
As with migraine disease and many other headache disorders, there is no definitive diagnostic test for hemicrania continua. When a person has symptoms of hemicrania continua, a trial of indomethacin may confirm the diagnosis.
Some studies have reported that cluster headaches have a much more adverse effect on the quality of life as compared to migraine headaches [11]. Symptoms of depression, anxiety, and suicidal thoughts are more common in patients with chronic headaches as compared to healthy controls [12].
HC is more common in women and most often starts in adulthood, but may begin anywhere from 5 to 67 years of age. Diagnosis of hemicrania continua (HC) is made by ruling out other possible causes of the pain and by clinical symptoms.
Sip a caffeinated drink.
In small amounts, caffeine alone can relieve migraine pain in the early stages. Caffeine also may enhance the pain-reducing effects of acetaminophen (Tylenol, others) and aspirin. Be careful, however. Drinking too much caffeine too often can lead to withdrawal headaches later on.
The "5 Cs of headaches" typically refer to common dietary migraine triggers: Cheese (aged), Chocolate, Coffee (caffeine), Cola (sugary/caffeinated drinks), and Citrus fruits, though some sources mention Claret (red wine) instead of cola or citrus, with the concept highlighting foods that can induce severe headaches in sensitive individuals, though scientific consensus varies on their universal impact. Another interpretation, less common, describes migraine symptoms as Crescendo, Crushing, Cranial, Consistent, and Cyclical, notes Bali International Hospital.
While anyone can have hemicrania continua, it's most common in people assigned female at birth. Hemicrania continua is treated by a doctor who specializes in neurological disorders called a neurologist.
The exact cause of ocular migraines isn't fully understood, but many researchers believe they're related to changes in blood flow to the eye or visual cortex in the brain. Certain triggers can increase the likelihood of an episode, including: Stress or anxiety. Bright or flickering lights.
Treatment for hemicrania continua primarily revolves around indomethacin, with medications such as celecoxib, topiramate, and gabapentin as potential alternatives for individuals who cannot tolerate indomethacin.
Many disorders that cause headaches, such as giant cell arteritis, brain tumors, and subdural hematomas (which may result from falls), are more common among older adults.
Primary headache doesn't typically have neurological symptoms associated with it, so if the patient is experiencing neurological signs, it may point to secondary headache. These symptoms can include weakness in one arm or leg, numbness that is new or not typical or any visual changes.
Characteristics of an Anxiety Headache
Individuals experiencing anxiety headaches often describe the pain as a dull, constant ache. It feels as if a tight band is wrapped around the head, exerting pressure. This sensation can be uncomfortable and distracting, making it challenging to focus on daily tasks.
Migraine with aura can closely mimic or resemble the symptoms of a stroke and several research studies have shown that people suffering with migraine attacks are at a slightly increased risk of stroke which can cause cognitive decline and memory loss.
The FDA has cleared an expanded indication for electroCore's gammaCore noninvasive vagus nerve stimulation (nVNS) to treat patients with paroxysmal hemicrania (PH) and hemicrania continua (HC) in adults, making it the first treatment—drug or device—to be approved for these patient populations.
Do Chronic Headaches Qualify Me for Disability Benefits? Chronic Headaches are not specifically listed in the Social Security Administration's “Blue Book” listing of disabling conditions – but you may still qualify for benefits.
The differential diagnoses of HC include long-lasting unilateral headaches (e.g., unilateral chronic migraine, the syndrome of new daily persistent headache [NDPH], cervicogenic headache) and unilateral short-lasting headaches with oculofacial autonomic accompaniments (trigeminal autonomic cephalgias), particularly PH, ...
Unlike other headaches, such as a migraine, that can be triggered by stress, certain foods or your environment, hemicrania continua often appears suddenly with no cause and sticks around. Further research is necessary to understand the underlying reasons for hemicrania continua to develop.
Hemicrania continua (HC) is an indomethacin responsive primary chronic headache disorder which is currently classified as a subtype of trigeminal autonomic cephalalgias (TACs). It is not very uncommon. There are >1000 cases of HC in the literature, and it constitutes 1.7% of total headache in the clinic settings.
Migraines aren't usually dangerous, but they greatly disrupt your life. They also increase your risk of life-threatening conditions like stroke and heart attack. Some migraine symptoms can also look like stroke symptoms. Because of that, chronic migraine needs expert monitoring and treatment.