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Case Reports in Medicine
Volume 2017, Article ID 5043471, 3 pages
https://doi.org/10.1155/2017/5043471
Case Report

Unilateral Headache Status after Intra-Aortic Balloon Pump Placement

1Department of Anesthesiology, Westchester Medical Center, Valhalla, NY 10595, USA
2Cardiac Transplantation and Mechanical Circulatory Support, Westchester Medical Center, Valhalla, NY 10595, USA

Correspondence should be addressed to Shalvi B. Parikh; gro.htlaehcmw@hkiraP.ivlahS

Received 18 May 2017; Accepted 2 July 2017; Published 27 July 2017

Academic Editor: Michael S. Firstenberg

Copyright © 2017 Garret M. Weber et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Introduction. Intra-aortic balloon pump (IABP) counterpulsation is a catheter-based treatment for coronary artery disease and decompensated heart failure to increase coronary blood flow and improve cardiac output. IABP is generally well tolerated, and complications are usually related to peripheral vasculature or red blood cell and platelet consumption. The usual insertion site via femoral artery renders the patient bedbound. Recently, axillary artery has been used in patients with atherosclerotic peripheral vascular disease and documented small arteries or in those awaiting transplant to ensure ambulation and prevent deconditioning. Case Report. We present a patient with ischemic cardiomyopathy and severe left ventricular dysfunction, awaiting Orthotropic Heart Transplant. His worsening intractable angina and dyspnea necessitated IABP placement via left axillary artery, significantly improving his condition. He subsequently experienced migraine-type persistent unilateral headache refractory to standard pain management. Multiple strategies were utilized to treat his pain, but the patient insisted that his pain commenced after IABP placement. Ultimately, the removal of the pump led to complete resolution with no recurrence. Conclusion. The authors hypothesize that the unilaterally directed blood flow and direct increase in cerebral perfusion from the intra-aortic balloon pump may have caused vasodilation of the extracranial arteries, leading to a persistent and debilitating headache in this susceptible patient.