LAUSR

We read the interesting report by Haan and Ferrari (1) regarding the headache from which the famous composer Gustav Mahler suffered. In their paper the authors argued that it could not be ruled out that this migrainous headache was associated with the endocarditis that would later be the cause of death of the artist, hypothesizing a so-called ‘Mahler’s migraine’ (1). To the best of our knowledge, other associations between endocarditis and the development of migraine-like headache have not been reported. We describe the case of a 44-year-old Russian woman who came to our attention for acute visual disturbances associated with headache. She had a long history of headache episodes characterized by bilateral, non-throbbing, occipital pain, occurring more than 10 times per month, lasting many hours, preceded by visual symptoms (scintillating scotoma) and accompanied by nausea, vomiting, photophobia and phonophobia. In childhood, the patient suffered from frequent sore throats; in the last 10 years she had persistent knee pain that limited her in working and, in the last two years, she also complained of wheezing while climbing the stairs. At the time of our observation, an ophthalmological evaluation revealed left upper