About 90% of the patients suffer from idiopathic headaches, for example, migraine or tension headaches, which are treated according to guidelines. An acute headache can however also be a symptom of a serious primary disease, such as subarachnoid hemorrhage, arterial dissection, cerebral infarction, cerebral venous thrombosis or acute glaucoma. Patients with suspected symptomatic headaches must be immediately referred to a specialist or hospital for further diagnosis and therapy 1).
Patients with optic chiasma cavernous malformation typically present with chiasmal apoplexy, characterized by sudden visual loss, acute headaches, retroorbital pain, and nausea 2).