Introduction

Compression of the duodenum and left renal vein between the aorta and superior mesenteric artery usually leads to symptoms of proximal bowel obstruction or hematuria and, more rarely, nonspecific mild headaches.

Case

A young woman presented with new daily persistent headache refractory to numerous pharmacological treatments, onabotulinumtoxinA, nerve blocks, and occipital nerve stimulation. Following several years of daily severe headache, worsening abdominal pain and intolerance for food intake led to the discovery of aortomesenteric compression. Surgical treatment gave prompt improvement in gastric symptoms but also essentially resolved the headache.

Conclusion

This is the first description of new daily persistent headache in association with aortomesenteric compression as well as marked improvement of headache following aortomesenteric decompression. In patients with new daily persistent headache and orthostatic symptoms one may consider a differential diagnosis of Nutcracker syndrome, especially in patients with comorbid hypermobility syndromes, hematuria or gastric symptoms.

中文翻译：

---

胡桃夹综合征模仿新的日常持续性头痛：病例报告。

介绍

主动脉和肠系膜上动脉之间十二指肠和左肾静脉受压通常会导致近端肠梗阻或血尿的症状，更罕见的是非特异性轻度头痛。

案件

一名年轻女性出现新的每日持续性头痛，对多种药物治疗、肉毒杆菌毒素 A、神经阻滞和枕神经刺激均无效。在数年的每日严重头痛之后，腹痛恶化和对食物摄入的不耐受导致了主动脉肠系膜压迫的发现。手术治疗迅速改善了胃部症状，但也从根本上解决了头痛。

结论

这是首次描述与主动脉肠系膜压迫相关的新的每日持续性头痛以及主动脉肠系膜减压后头痛的显着改善。对于每天出现新的持续性头痛和直立症状的患者，可以考虑与胡桃夹子综合征进行鉴别诊断，尤其是合并过度活动综合征、血尿或胃部症状的患者。