Cerebral Arterial Occlusion and Cluster Headaches in Neurofibromatosis

Cluster headache, a variant of migrainous encephalalgia, is rarely encountered in childhood. A 3½-year-old child, with cutaneous manifestations of neurofibromatosis, exhibited an episodic symptom complex consisting of unilateral facial pain, ipsilateral ptosis, lacrimation, and rhinorrhea. Neurologic investigation included cerebral angiography, which demonstrated occlusion of the right internal carotid artery. A causal relation between the patient's headache complaints and the vascular anomaly seemed likely, although the pathophysiological mechanism for the association remains speculative.