连续性偏头痛是一种原发性单侧头痛，其特征为同侧副交感神经和交感神经自主神经特征。一个关键的诊断标准是其对吲哚美辛治疗的显着反应；然而，据报道，各种血管或结构异常可导致继发性连续性偏头痛，其临床特征与原发性头痛相似。我们回顾了文献，汇编了继发性连续性偏头痛病例，强调了影像学检查在评估过程中的重要性。此外，我们还为现有研究贡献了三个病例。我们对 PubMed 和 EMBASE 数据库中的文章进行了回顾，这些文章描述了 1993 年至 2021 年期间报道的继发性持续性偏头痛病例。我们的回顾包括详细的患者信息、体征和持续性偏头痛的症状，以及吲哚美辛使用和头痛缓解的信息（如果相关）。继发性持续性偏头痛可能是由多种不同的结构和血管病变引起的，但缺乏长期随访的临床报告。值得注意的是，病例可能表现出对吲哚美辛的经典反应，强调了神经影像学在排除继发病例中的重要性。我们的搜索找到了 41 个符合我们标准的案例。我们排除了六例未接受吲哚美辛治疗或对其无反应的病例。此外，我们还提出了三个案例，强调了神经影像学在评估连续性偏头痛中的必要性，以及吲哚美辛和病变导向治疗后的短期和长期临床结果。病例 1 每天出现右侧头痛和颅自主神经症状。使用吲哚美辛后，她的疼痛完全消失。大脑神经影像显示右侧颈内动脉存在横向囊状动脉瘤。病例 2 表现为持续性左侧单侧头痛，并叠加加重。她主诉左侧畏光，左耳感觉迟钝。使用吲哚美辛两周后，她的症状减轻。头部神经影像显示良性肿瘤，左侧延髓和小脑下脚有占位效应。病例 3 表现为右侧闭锁性头痛，并每日严重叠加加重。她右眼患有畏光症，患有右侧霍纳氏综合症，病情恶化时还会流泪。大脑神经影像检查显示她患有垂体肿瘤，并且用吲哚美辛完全缓解了她的疼痛。连续性偏头痛是一种罕见的头痛疾病，可以是原发性或继发性。重要的是，继发性持续性偏头痛中仍可能出现对吲哚美辛的反应。因此，无论对吲哚美辛治疗的临床反应如何，都应考虑神经影像学检查以排除所有病例的潜在结构性病因。© 2024 作者。头痛：《头面部疼痛杂志》由 Wiley periodicals LLC 代表美国头痛协会出版。

Hemicrania continua is a primary unilateral headache characterized by ipsilateral parasympathetic and sympathetic autonomic features. A key diagnostic criterion is its dramatic response to indomethacin treatment; however, various vascular or structural abnormalities have been reported to cause secondary hemicrania continua, presenting with clinical features similar to those of the primary headache presentation.We reviewed the literature to compile secondary hemicrania continua cases, highlighting the importance of imaging during the evaluation. Additionally, we also contributed our three cases to the existing studies.We conducted a review of articles from the PubMed and EMBASE databases that described reported cases of secondary hemicrania continua, covering the period from 1993 to 2021. Our review included detailed patient information, signs, and symptoms of hemicrania continua, as well as information on indomethacin usage and headache resolution (if pertinent).Secondary hemicrania continua can result from a remarkably diverse range of structural and vascular lesions, yet clinical reports on long-term follow-up are lacking. Notably, cases may exhibit a classical response to indomethacin, emphasizing the importance of neuroimaging in excluding secondary cases. Our search yielded 41 cases meeting our criteria. We excluded six cases that were not treated with indomethacin or were unresponsive to it. Additionally, we present three cases that highlight the necessity of neuroimaging in evaluating hemicrania continua, along with short- and long-term clinical outcomes following indomethacin and lesion-directed treatments. Case 1 presented with daily right-sided headaches and cranial autonomic symptoms. Her pain completely resolved with indomethacin use. Neuroimaging of the brain revealed a laterally directed saccular aneurysm of the right internal carotid artery. Case 2 presented with continuous left-sided unilateral headaches with superimposed exacerbations. She complained of left-sided photophobia with a dull sensation in the left ear. Her symptoms decreased after 2 weeks of indomethacin use. Neuroimaging of the head indicated a benign tumor with mass effect into the left lateral medulla and inferior cerebellar peduncle. Case 3 presented with a right side-locked headache with daily, severe superimposed exacerbations. She had photophobia in the right eye and a right-sided Horner's syndrome, along with tearing during her exacerbations. Neuroimaging of the brain revealed a pituitary tumor and her pain completely resolved with indomethacin.Hemicrania continua is a rare headache disorder that can be either primary or secondary. Importantly, response to indomethacin can still occur in secondary hemicrania continua. Thus, neuroimaging should be considered to rule out underlying structural etiology in all cases, regardless of their clinical responsiveness to indomethacin therapy.© 2024 The Authors. Headache: The Journal of Head and Face Pain published by Wiley Periodicals LLC on behalf of American Headache Society.