Under Pressure?

In this report, the authors describe a 54-year-old woman who presented with a 2-month history of recurrent, unilateral hypnic headache. She had a history of migraine and medication-overuse headache. The hypnic headache decreased in frequency after treatment with ramipril.

The authors also reviewed the literature on hypnic headache and identified 101 case reports, including information on comorbidities, medications, and results of clinical investigations and therapy. They recommend 24-hour ambulatory blood-pressure monitoring as part of the diagnostic work-up in older patients who present with hypnic headache.