Hypothalamic Deep Brain Stimulation for Intractable Cluster Headache: Case Report and Review of Literature

Lee, Myung Ki; Jeun, Seung Man

Case report

Journal of the Korean Society of Stereotactic and Functional Neurosurgery 2010;6(1):68-70.
Published online June 30, 2010.

Hypothalamic Deep Brain Stimulation for Intractable Cluster Headache: Case Report and Review of Literature

Myung Ki Lee, Seung Man Jeun

Department of Neurosurgery On General Hospital, Busan, KoreaDepartment of Neurology, Bongseng Memorial Hospital, Busan, Korea

Abstract

Functional imaging data has revealed that hyperactivity of the ipsilateral posterior hypothalamus plays a key role in cluster headache (CH) ; therefore it has become a potential target of deep brain stimulation (DBS) for intractable CH therapy. However, the widespread clinical application of this technique is still controversial. We describe the case of a 60-year-old man with intractable CH for at least 2 year, despite medical treatment and surgical procedures including open microvascular decompression and percutaneous balloon compression of the trigeminal ganglion. He underwent DBS of the ipsilateral posterior hypothlamus and obtained headache relief without significant side effects during the follow-up of 4 years. It is suggested that hypothalamic DBS is one option for the treatment of chronic intractable CH that does not respond to less invasive or conservative treatment options.

Key Words: Hypothalamus, Cluster headache, Deep brain stimulation.