- Any new headache fulfilling criterion C
- A dural arteriovenous fistula (DAVF) has been diagnosed
- Evidence of causation demonstrated by at least two of the following:
- headache has developed in close temporal relation to other symptoms and/or clinical signs of DAVF, or has led to the diagnosis of DAVF
- either or both of the following:
- – headache has significantly worsened in parallel with other symptoms or clinical or radiological signs of growth of the DAVF
- – headache has significantly improved or resolved after effective treatment of the DAVF
- at least one of the following:
- – headache is accompanied by pulsatile tinnitus
- – headache is accompanied by ophthalmoplegia
- – headache is both progressive and worse in the morning and/or during coughing and/or bending over
- headache is localized to the site of the DAVF
- Not better accounted for by another ICHD-3 diagnosis1.
In particular, intracerebral haemorrhage and cerebral venous thrombosis have been excluded by appropriate investigations.
Studies devoted to 6.3.3 Headache attributed to dural arteriovenous fistula are lacking. A painful pulsatile tinnitus can be a presenting symptom, as well as headache with features of intracranial hypertension due to decrease in venous outflow and sometimes to sinus thrombosis. Carotidocavernous fistulae may present as painful ophthalmoplegia.