Visual aura in ice cream headache

We present a case of cold-induced visual symptoms in a 74-year-old woman with a history of migraine headaches. Migraine without aura was the starting symptom. It coexisted later with a typical pain of ice cream or cold stimulus headache that persisted after the migraine vanished. Finally the headache disappeared and the course was characterised by episodes of pure visual symptoms, always after swallowing cold material. The vasodynamic effects underlying migraine are invoked to understand this case, but the activation of the trigeminal system provides a better explanation for the symptoms of this patient. Thus trigeminal activated headache and aura could include a subform like this one, characterised by pure hemianopsia after ingesting cold material.