Abstract
According to IHS (International Headache Association) recommendations, it is mandatory to rule out symptomatic origin in the work up of trigeminal autonomic cephalalgias. Although this group is uncommon, if untreated, it could represent a life threatening event or become a cause of intractable headache. We discuss a patient who was admitted to the emergency service suffering from a kind of headache that initially was diagnosed as a primary headache (Cluster headache). Taking into account the poor response with medications and the absence of full International headache criteria (IHS) was necessary to practice a broader work up finding a bacterial sinusitis in the magnetic resonance images.
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