Stephen D. Silberstein

Paroxysmal Headache Caused by Colloid Cyst of the Third Ventricle: Case Report and Review of the Literature

Colloid cysts of the third ventricle are benign tumors that may cause brief, severe headache and, rarely, death. We present a patient with frequent, episodic, brief, severe headaches of 2 weeks duration who suddenly became obtunded. We reviewed the literature on the symptomatology of colloid cysts and conclude that any patient: with less than a 1‐year history suggestive of a third ventricular colloid cyst causing brief, severe headaches should be aggressively investigated.

Droperidol Treatment of Status Migrainosus and Refractory Migraine

We conducted a pilot study of intravenous droperidol in 35 patients (32 women and 3 men; mean age 43 years) with status migrainosus (n=25) or refractory migraine (n=10) in an ambulatory infusion center. Headache was graded as severe in 21 patients and moderate in 14. An intravenous line was started and kept open. Droperidol (2.5 mg) was given intravenously every 30 minutes until either three doses were given or the patient was completely or almost headache‐free prior to the next dose.

Migraine‐Related Stroke Versus Migraine‐Induced Stroke

The authors concluded, “All four patients came under the definition of migrainous stroke as proposed in the IHS classification.” They then challenge the IHS definition because it limits migrainous infarction only to patients with migraine with aura. They use an expanded classification of migraine-related stroke proposed by Welch and Levine3 to include the two patients who presented with stroke in the setting of migraine without aura.