A cluster-tic syndrome: a case report CASE REPORT Zoran Vukojevic 1 , Aleksandra Dominovic-Kovacevic 1 , Sanja Grgic 1 , and Srdjan Mavija 1 1 Department of Neurology, University clinical center of Republic of Srpska, Banja Luka, Bosnia and Herzegovina Correspondence: Srdjan Mavija Relje Krilatice 7, Banja Luka 78000, Bosnia and Herzegovina. Email: smavija@yahoo.com Introduction: Cluster headaches and trigeminal neuralgia have typical clinical features with recurrent, attacks of severe pain in orbito-temporal area along with unilateral lacrimation and rhinorrhea (cluster headache) or within the innervation area of the roots of trigeminal nerve branches (trigeminal neuralgia). Co-occurrence of these two conditions, as it is often referred in the literature, is named cluster-tic syndrome. Case report: A 46-year-old, female patient was presented with episodic form of cluster headaches and concurrent trigeminal neuralgia. Painful attacks had a different time distribution and matching localization. Specific treatment led to relief in both types of headaches. MRI of the brain showed aberrant superior cerebellar artery which contacts with proximal segments of right trigeminal nerve, possibly leading to neuropathic pain. Discussion: Cluster headache has characteristic clinical presentation with intermittent, recurrent, severe pain and dysau- tonomic features in the orbito-temporal area, specific treatment of acute pain attacks (oxygen inhalation, subcutaneous sumatriptan injections) and specific prevention therapy (verapamil, prednisone), different from other primary headaches. Trigeminal neuralgia is presented with attacks of stabbing unilateral facial pain following the sensory distribution of one or more of the branches of trigeminal nerve. Both conditions are rare and its association is even more rare and called cluster-tic syndrome and they produce a strong and exhausting pain which requires a immediate attention and treatment. Keywords: Cluster headache, Trigeminal neuralgia, Cluster-tic syndrome. Citation: Vukojevic et al. A cluster-tic syndrome: a case report. International Journal of Clinical Neurosciences and Mental Health 2016; 3(Suppl. 1):S16 DOI: http://dx.doi.org/10.21035/ijcnmh.2016.3(Suppl.1).S16 Published: 23 December 2016 © 2016 Vukojevic 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. Open Access Publication Available at http://ijcnmh.arc-publishing.org INTERNATIONAL JOURNAL OF AND CLINICAL NEUROSCIENCES MENTAL HEALTH Special Issue on Controversies in Neurology. From the 10 th World Congress on Controversies in Neurology (CONy), Lisbon, Portugal. 17–20 March 2016. Abstract