"Sinto uma vontade irresistível de bater a cabeça na parede": uma série de casos que destaca agitação e dor intensa na cefaleia em salvas
Views: 51DOI:
https://doi.org/10.48208/HeadacheMed.2025.29Palavras-chave:
Cefaleia em salvas, Agitação psicomotora, Bater a cabeça, Comportamento autolesivo, Cefaleia autonômica trigeminalResumo
Resumo
Introdução
A cefaleia em salvas é uma cefaleia primária caracterizada por dor unilateral intensa, tipicamente associada a sintomas autonômicos cranianos, incluindo hiperemia conjuntival, lacrimejamento, congestão nasal, rinorreia, edema palpebral, sudorese frontal e facial, miose e ptose palpebral. Além dessas características marcantes, os pacientes frequentemente apresentam agitação psicomotora acentuada, às vezes expressando o desejo de bater a cabeça como uma resposta instintiva à dor insuportável.
Relato de casos
Esta série de casos destaca três desses pacientes. Em todos os casos, terapias preventivas adequadas reduziram tanto a frequência das crises quanto o desejo de comportamento autolesivo.
Conclusão
Esses relatos destacam o sofrimento extremo associado à cefaleia em salvas e enfatizam a importância do reconhecimento oportuno e de estratégias de tratamento eficazes.
Downloads
Referências
de Freitas Dias B, Robinson CL, Villar-Martinez MD, Ashina S, Goadsby PJ. Current and Novel Therapies for Cluster Headache: A Narrative Review. Pain Ther. 2025;14(2025):1-19. Doi: 10.1007/s40122-024-00674-7 DOI: https://doi.org/10.1007/s40122-024-00674-7
Xu XH, Li YM, Ren LN, Xu XF, Dai YL, Jin CQ, Yang RR. Cluster headache: understandings of current knowledge and directions for whole process management. Front Neurol. 2024;15(2024):1456517. Doi: 10.3389/fneur.2024.1456517. DOI: https://doi.org/10.3389/fneur.2024.1456517
Burish M. Cluster Headache, SUNCT, and SUNA. Continuum (Minneap Minn). 2024;30(2024):391-410. Doi: 10.1212/CON.0000000000001411. DOI: https://doi.org/10.1212/CON.0000000000001411
Torelli P, Manzoni GC. Behavior during cluster headache. Curr Pain Headache Rep. 2005;9(2005):113-9. Doi: 10.1007/s11916-005-0048-x.
Luerding R, Henkel K, Gaul C, Dresler T, Lindwurm A, Paelecke-Habermann Y, et al. Aggressiveness in different presentations of cluster headache: Results from a controlled multicentric study. Cephalalgia. 2012;32(2012):528-36. Doi: 10.1177/0333102412443336. DOI: https://doi.org/10.1177/0333102412443336
Yulug B, Hanoglu L, Schabitz WR. Headache and spontaneous glabellar ecchymosis: More than a self‐injury behavior? Psychiatry and Clinical Neurosciences. 2014;69(2014):124-. Doi: 10.1111/pcn.12220. DOI: https://doi.org/10.1111/pcn.12220
Torelli P, Manzoni GC. Behavior during cluster headache. Current Pain and Headache Reports. 2005;9(2005):113-9. Doi: 10.1007/s11916-005-0048-x. DOI: https://doi.org/10.1007/s11916-005-0048-x
Bertotti G, Fernandez-Ruiz V, Roldan-Ruiz A, Lopez-Moreno M. Cluster Headache and Migraine Shared and Unique Insights: Neurophysiological Implications, Neuroimaging, and Biomarkers: A Comprehensive Review. J Clin Med. 2025;14(2025). Doi: 10.3390/jcm14072160. DOI: https://doi.org/10.3390/jcm14072160
Abagnale C, Di Renzo A, Giuliani G, Sebastianelli G, Casillo F, Ziccardi L, et al. MRI-based analysis of the microstructure of the thalamus and hypothalamus and functional connectivity between cortical networks in episodic cluster headache. J Headache Pain. 2025;26(2025):12. Doi: 10.1186/s10194-024-01920-1. DOI: https://doi.org/10.1186/s10194-024-01920-1
Chiffi D, Di Renzo A, Giuliani G, Abagnale C, Altieri M, Sebastianelli G, et al. Assessment of hypothalamic macrostructure in episodic cluster headache: a volumetric segmentation MRI study. Radiol Med. 2025;130(2025):1483-8. Doi: 10.1007/s11547-025-02041-8. DOI: https://doi.org/10.1007/s11547-025-02041-8
Coppola G, Abagnale C, Sebastianelli G, Goadsby PJ. Pathophysiology of cluster headache: From the trigeminovascular system to the cerebral networks. Cephalalgia. 2024;44(2024):3331024231209317. Doi: 10.1177/03331024231209317. DOI: https://doi.org/10.1177/03331024231209317
Bai F, Huang L, Deng J, Long Z, Hao X, Chen P, et al. Prelimbic area to lateral hypothalamus circuit drives social aggression. iScience. 2023;26(2023):107718. Doi: 10.1016/j.isci.2023.107718. DOI: https://doi.org/10.1016/j.isci.2023.107718
Rizzi M, Gambini O, Marras CE. Posterior hypothalamus as a target in the treatment of aggression: From lesioning to deep brain stimulation. Handb Clin Neurol. 2021;182(2021):95-106. Doi: 10.1016/B978-0-12-819973-2.00007-1. DOI: https://doi.org/10.1016/B978-0-12-819973-2.00007-1
Vilela-Filho O. Commentary: Amygdala and Hypothalamus: Historical Overview With a Focus on Aggression. Neurosurgery. 2019;85(2019):E1-E3. Doi: 10.1093/neuros/nyz045. DOI: https://doi.org/10.1093/neuros/nyz045
Gouveia FV, Hamani C, Fonoff ET, Brentani H, Alho EJL, de Morais R, et al. Amygdala and Hypothalamus: Historical Overview With Focus on Aggression. Neurosurgery. 2019;85(2019):11-30. Doi: 10.1093/neuros/nyy635. DOI: https://doi.org/10.1093/neuros/nyy635
Chang CH, Gean PW. The Ventral Hippocampus Controls Stress-Provoked Impulsive Aggression through the Ventromedial Hypothalamus in Post-Weaning Social Isolation Mice. Cell Rep. 2019;28(2019):1195-205 e3. Doi: 10.1016/j.celrep.2019.07.005. DOI: https://doi.org/10.1016/j.celrep.2019.07.005
Haller J. The Role of the Lateral Hypothalamus in Violent Intraspecific Aggression-The Glucocorticoid Deficit Hypothesis. Front Syst Neurosci. 2018;12(2018):26. Doi: 10.3389/fnsys.2018.00026. DOI: https://doi.org/10.3389/fnsys.2018.00026
Hashikawa Y, Hashikawa K, Falkner AL, Lin D. Ventromedial Hypothalamus and the Generation of Aggression. Front Syst Neurosci. 2017;11(2017):94. Doi: 10.3389/fnsys.2017.00094. DOI: https://doi.org/10.3389/fnsys.2017.00094
Vaughan R. My Own Private Purgatory: How Cluster Headaches Affect My Life. Headache: The Journal of Head and Face Pain. 2008;48(2008):1541-3. Doi: 10.1111/j.1526-4610.2008.01303.x. DOI: https://doi.org/10.1111/j.1526-4610.2008.01303.x
Headache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders, 3rd edition. Cephalalgia. 2018;38(2018):1-211. Doi: 10.1177/0333102417738202. DOI: https://doi.org/10.1177/0333102417738202
Downloads
Publicado
Como Citar
Edição
Seção
Licença
Copyright (c) 2025 Marcelo Moraes Valença, Rita Santana dos Reis, Juliana Ramos de Andrade (Author)
Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.
