Céphalée unilatérale référée par compression thoracique du nerf vague

Atypical headaches with normal etiological explorations and unsuccessful treatment should lead to chest imaging, particularly to rule out lung cancer. We report herein the case of a 48-year-old man with refractory unilateral occipito-auricular headache for whom lung cancer was diagnosed 9 months after headache onset. The association between unilateral facial pain with lung cancer has already been reported. However referred occipito-auricular pain has not yet been described in the same situation. The clinical presentation and pathophysiology of this referred pain supposedly due to thoracic compression of the vagus nerve are discussed herein.