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February 1976

Posttraumatic Dysautonomic Cephalalgia-Reply

Arch Neurol. 1976;33(2):144. doi:10.1001/archneur.1976.00500020072015

In Reply.—  We are grateful for the comments by Dr Kudrow. We believe that the variety of post-traumatic headaches described by us is different from what was described by Simons and Wolff1 in 1946, and the reasons for this have been discussed in the original article. We have also made it clear that injury to the sympathetic fibers in the neck is assumed. However, it should be pointed out that all patients had evidence of soft tissue injury either directly or indirectly involving the carotid sheath region at the time of the original trauma. We have recently seen two more patients with the same kind of headaches following direct injury to the carotid sheath region. Thus, the cause and effect relationship, seems to be consistent.The autonomic disturbances in our patients were different and more widespread than those seen in patients with cluster headaches, who usually have a transient and partial