Abstract
A 68-year-old man with chronic lung disease suffered from cluster headache (CH)-like pain associated with an upper cervical meningioma extending to compress the lower brain stem. The pain disappeared after tumour excision. We suggest that compression of the brain stem and hypoxemia associated with chronic lung disease might have caused the attacks. especially in the early morning when REM sleep hypoxia was prevalent. It is also suggested that in atypical resistant cases of CH-like pain where therapy fails. efforts should be made to rule