8.1.6.1 Immediate histamine-induced headache

Identification: A 32-year-old male patient reports recurrent episodes of sudden bilateral headache following the use of medications or foods rich in histamine. Clinical History: Chief Complaint: Moderate, bilateral, pulsatile headache lasting 40 minutes, triggered 30 minutes after ingestion of red wine or aged cheeses. Associated Symptoms: Ipsilateral tearing and mild nasal congestion during the episode. Frequency: 3 to 4 episodes in the last 2 months. Triggering Factors: Consumption of foods rich in histamine (red wine, cheeses, smoked fish) and use of vasodilator medication (reported an episode after taking nitroglycerin for non-cardiac chest pain). Relief: Spontaneous improvement without the use of analgesics. Physical/Neurological Examination: Unremarkable.