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The Journal of Headache and Pain

Official Journal of the "European Headache Federation" and of "Lifting The Burden - The Global Campaign against Headache"

The Journal of Headache and Pain Cover Image

Volume 16 Supplement 1

1st Joint ANIRCEF-SISC Congress

Open Access

P036. Headache attributed to non-traumatic intracranial bleeding

  • Rita Lucia Trinchi1Email author,
  • Francesco Migliorini1 and
  • Francesco Odoguardi2
The Journal of Headache and Pain201516(Suppl 1):A174

Published: 28 September 2015


Contrast MediumIntracerebral BleedingSudden OnsetVascular MalformationTemporal Level


Headache attributed to non-traumatic intracranial bleeding is classified by the ICHD-2 and the ICHD-3 Beta criteria at code 6.2.1.

In the ICHD-2 classification at code 6.3.4 is classified headache attributed to cavernous angioma as a result of intracerebral bleeding, while in the ICHD-3 beta version at the same code, the headache is closely linked to vascular malformation and not bleeding [1, 2].

Case report

A male patient, 37 years old, married with 2 children, came to our observation with a history of 7 days of headache.

Seven days before, at 3.30 am, he experienced a sudden onset of headache which in 2-3 minutes became severe, accompanied by paresthesia of the left upper limb, chest, right upper limb, lower limb, with tightness of the throat, unconsciousness and spreading of tremors.

The patient was taken with an ambulance to the nearest Spoke Center, where a Stress Syndrome was diagnosed and treated with BDZ and discharged at 12.00 am.

In the following three days the patient reported a state of drowsiness and headache lasting for 6-7 hours daily, bilateral, at the temporal level, of pulsating nature, accompanied by sweating, photophobia, and phonophobia. Physical effort was a trigger factor.

Given the brief medical history and absence of diseases worthy of note, the patient underwent imaging techniques: first CT and CT angiography, which excluded pathologies, then RMN and AngioRMN with and without contrast medium which showed a cavernous angioma in the left juxtacortical occipital, with signs of intralesional bleeding.


The patient bearer of cavernous angioma had never previously suffered from headaches, and current symptoms are closely related to intralesional bleeding.

Written informed consent to publish was obtained from the patient(s).

Authors’ Affiliations

Centro Cefalee, Ospedale G. Chidichimo, Trebisacce, Italy
U.O. Radiologia, Ospedale G. Chidichimo, Trebisacce, Italy


  1. Headache Classification Subcommittee of the International Headache Society: The International Classification of Headache Disorders, 2nd edn. Cephalalgia. 2004, 24 (Suppl 1): 1-160.Google Scholar
  2. Headache Classification Committee of the International Headache Society (IHS): The International Classification of Headache Disorders, 3rd edition (beta version). Cephalalgia. 2013, 33 (9): 629-808.View ArticleGoogle Scholar


© Trinchi et al. 2015

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.


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