Probable hemicrania continua temporally associated with cataract extraction: a case report

Hemicrania continua (HC) is a rare primary headache disorder characterized by continuous unilateral pain, cranial autonomic features, and absolute responsiveness to indomethacin. While HC typically occurs spontaneously, secondary cases following surgical triggers such as ocular procedures are considered rare. A 58-year-old Syrian male developed persistent right-sided ocular pain and conjunctival redness refractory to standard therapies after uncomplicated cataract surgery. The clinical features were suggestive of probable hemicrania continua, with complete resolution following indomethacin. HC should be considered in the differential diagnosis of persistent unilateral ocular pain following cataract surgery. Although a causal relationship cannot be established, the temporal association with cataract surgery suggests that ocular surgery may have acted as a possible trigger in a susceptible individual. This case highlights the importance of considering an indomethacin-responsive trigeminal autonomic cephalalgia in patients with persistent unilateral ocular pain after surgery.