Chronic pelvic inflammatory context leading to migraine exacerbation: a case report
Abstract
Case presentation: Woman, 48 years old, infertile, with dysmenorrhea, episodic headache since the age of 35 with weekly attacks and worsening related to the menstrual cycle. In 2020, she developed a sudden onset of dyspnea and chest pain, during menstruation which progressed to pneumothorax. A biopsy of the right upper lung lobe identified subpleural emphysema which, associated with the clinical picture of intense dysmenorrhea and magnetic resonance imaging of the pelvis, was presumptively diagnosed as a pulmonary focus of endometriosis. The patient has been menopausal since 2023 with worsening of migraine symptoms. In gynecological investigation, signs of hypoestrogenism were noted, vulvar atrophy associated with fissures in the vestibule after physical examination, cervix posterior and lateralized to the left, hypotrophic vaginal walls, shortening of the left parametrium painful upon mobilization, thickening of the endopelvic fascia and intense dysmenorrhea. After the pneumothorax, the dysmenorrhea maintained the same pattern with the headache becoming daily, located in the right temporo-occipital region, intense and pulsatile, radiating to the right hemiface with intra and extracranial allodynia, followed by progressive course, accompanied by aura with nausea, blurred vision, scotomas, photophobia and phonophobia. In the post-crisis period, there is a change in mood and hyporexia. Discussion: Endometriosis is a chronic gynecological condition characterized by the presence…
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