Abstract
Abstract Objective: We present a rare case of Tic-cluster in the context of venous compression of the trigeminal nerve. Background: Cluster-Tic syndrome is a rare headache condition with features of both trigeminal neuralgia (Tic) and trigeminal autonomic cephalalgia symptom (TAC). Methods: Case report and review of literature. Results: A 75-year old man presents with left sided paroxysmal pain consistent with trigeminal neuralgia (Tic). Magnetic resonance demonstrated a venous compression of the posterior-medial aspect of the left trigeminal ganglion. He underwent microvascular decompression which confirmed petrosal vein compression with subsequent symptomatic resolution. After two years of remission, he had a new left unilateral throbbing headache consistent with International Classification of Headache Disorders (ICHD)- 3 cluster headache definition, which improved with steroids. Conclusion: Cluster-Tic syndrome has variable clinical presentations. Tic can precede cluster and the possible role of venous trigeminal compression in this headache remains unclear.
Highlights
Cluster-Tic syndrome is a rare headache condition with features of both trigeminal neuralgia (Tic) and trigeminal autonomic cephalalgia symptom (TAC)
A 75-year old man presents with left sided paroxysmal pain consistent with trigeminal neuralgia (Tic)
Magnetic resonance demonstrated a venous compression of the posterior-medial aspect of the left trigeminal ganglion
Summary
A 75-year old man presents with left sided paroxysmal pain consistent with trigeminal neuralgia (Tic). Magnetic resonance demonstrated a venous compression of the posterior-medial aspect of the left trigeminal ganglion. He underwent microvascular decompression which confirmed petrosal vein compression with subsequent symptomatic resolution. After two years of remission, he had a new left unilateral throbbing headache consistent with International Classification of Headache Disorders (ICHD)- 3 cluster headache definition, which improved with steroids
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