摘要:

SYNOPSISSubstance P (SP) neurons, with bipolar axons from the cell body, in sensory ganglia, exhibit unique properties in that impulses may travel either orthodromically or antidromically in the various ramifications of the axons, and that the transmitter may be released both in the central and peripheral ends of the neuron. Thus, these nerves are not only sensory, carrying nociceptive impulses from the periphery, but also motor with ability to dilate blood vessels, constrict smooth muscle cells and cause protein extravasation, glandular secretion, release from mast cells and excitation of autonomic ganglion cells. Within the individual neuron several local reflex arches ‐ axon reflexes ‐ are established in this way.An hypothesis is forwarded about the pathophysiology of cluster headache, against the background of recent morphological and functional evidence for SP neurons in the ipsilateral trigeminal nerve and its connections to various cranial structures including the sphenopalatine (pterygopalatine) ganglion and internal carotid perivascular nerve plexus. Activation of SP fibers in the ophthalmic and maxillary divisions may give rise to practically all symptoms of an attack of cluster headache. This provides a rational explanation for the beneficial effect on both pain and vegetative symptoms achieved by blockade of the Gasserian or sphenopalatine ganglia in this disease. A temporary arrest of central inhibitory serotonergic impulses presynaptically on the SP neurons in the caudal trigeminal nucleus is, with our present knowledge, a likely explanation for such an activation, even if it may not be the only factor. A comparison is made with the present opinion on activation of parasympathetic and blockade of sympathetic nerves to explain the various symptoms of a cluster att

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1984.hed2406294.x

出版商:Blackwell Science Inc    

年代:1984

数据来源: WILEY

摘要:

SYNOPSISThe somatotopic representation of the cranial dura mater and the major cerebral arteries in the semilunar ganglion of the cat has been studied experimentally. Neuroanatomical tracer substance was applied to various dural sites as well as to the internal carotid and middle cerebral artery and labeled cells were subsequently identified in the trigeminal ganglion. Cells in the first trigeminal division were found to innervate the medial aspect of the anterior cranial fossa, the tentorium cerebelli and the intracranial carotid and the middle cerebral artery. Neurons associated with the orbital roof were located predominantly in the dorsal and intermediate layers of the second division while the dura of the middle fossa was represented mainly in the dorsal strata of the third division. Labeled cells were smaller than the average ganglion cell.

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1984.hed2406305.x

出版商:Blackwell Science Inc    

年代:1984

数据来源: WILEY

摘要:

SYNOPSISCluster headache has a number of distinct features in the periodicity and frequency of headache and associated phenomena such as, ipsilateral rhinorrhoea and lacrimation. In some cases, however, it may be difficult to confirm diagnosis and apply the appropriate treatment. Lithium is beneficial in cluster headache but would exacerbate migraine. Hence there is a need for diagnostic methods for migraine or migraine subtypes and cluster headache. We have found that one readily measured parameter, erythrocyte choline, is significantly depressed in cluster headache patients both during and between attacks and this may therefore offer an aid to diagnosis. Further analysis of the pathways giving rise to this abnormality may give insight to the aetiology of cluster headache, as discussed below.

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1984.hed2406310.x

出版商:Blackwell Science Inc    

年代:1984

数据来源: WILEY

摘要:

SYNOPSISAn open trial of long‐term prophylactic therapy with Verapamil (240 mg/day) was completed in 44 patients with different types of chronic headache including: classic migraine (N = 15), common migraine (N = 11 ), cluster headache (N = 14), and muscle contraction headache (N = 4). Results were compared with similar trials utilizing Nifedipine and Nimodipine. Cerebral blood flow was measured before and after treatment. All three drugs block Ca2+entry into vascular smooth muscle and were effective in prophylactic treatment of migraine and cluster headaches but not in muscle contraction headaches. Treatment with Verapamil for 2‐3 weeks abolished or attenuated migraine prodromes, decreased headache frequency in cluster and classic migraine, but were less effective in common migraine. Cerebrovascular resistance was significantly reduced by Verapamil, confirming its vasodilator effects. Side effects were less common with Verapamil than with Nifedipine and included postural hypotension, constipation and skin rash. Decreased efficacy after long‐term treatment with Verapamil responded to dose increases. Experience in this laboratory with Nimodipine, Verapamil and Nifedipine indicates that all are effective in prophylactic treatment of vascular headache in that order of prefe

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1984.hed2406313.x

出版商:Blackwell Science Inc    

年代:1984

数据来源: WILEY

摘要:

SYNOPSISTwo hundred twenty nine psychiatric consultations of patients with headache were reviewed. A search was made for the presence of stress or conflict, preceding and maintaining the headache. The major finding was the patients' inability to cope with stress or conflict threatening their self‐esteem. Anxiety level was raised when issues of inadequacy, insecurity and helplessness surfaced. In predisposed individuals, defenses against or repressed responses to loss of self‐esteem were manifested by anger, anxiety, depression and heada

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1984.hed2406322.x

出版商:Blackwell Science Inc    

年代:1984

数据来源: WILEY

摘要:

SYNOPSISIntranasal spur pathology is presented as an easily diagnosed and readily correctable cause of facial pain within the confines of proper diagnostic evaluation and thorough elimination of other more serious causes of facial pain and headache.

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1984.hed2406329.x

出版商:Blackwell Science Inc    

年代:1984

数据来源: WILEY

摘要:

SYNOPSISAlthough the relationship between EMG levels and tension headache remains unclear, elevated frontalis EMG levels in tension headache sufferers are usually assumed to be part of the debilitating experience of headache. Elevated tension levels are seldom considered in an activation‐type framework. Consequently, headache patients are encouraged to relax in almost all situations. Two experiments were performed to examine whether tension headache sufferers showed any benefits from elevated tension levels during periods demanding a sustained level of cognitive efficiency. Headache subjects were compared with non‐headache subjects during discrimination and reaction time task performance across three levels of frontalis tension. Both groups' performance improved under increasing tension conditions relative to the low tension condition. In both experiments improvement was noted as a reduction in the most extreme scores, reflecting possible “mental blocks“. In Experiment 2 median reactions times were also affected. In Experiment I the variation in reaction time scores across the tension levels was greater in the headache group than the non‐headache group. Even when the optimal level of tension varied across task difficulty levels, low frontalis tension was never the optimal condition. It was concluded that tension headache prone individuals being treated by relaxation or biofeedback techniques need to be informed about the increased tendency towards slower responding under conditions of frontalis r

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1984.hed2406331.x

出版商:Blackwell Science Inc    

年代:1984

数据来源: WILEY

摘要:

SYNOPSISTo study the role of the proaggregatory, vasoconstrictory thromboxane A2(TxA2) in migraine, the plasma levels of Thromboxane B2(TxB2), the stabile metabolite of TxA2, were measured from 14 adults and 8 children with migraine during the attack‐free interval. In addition, the platelets' capacity to generate TxB2during spontaneous clotting was studied. The plasma TxB2concentrations were lowered in the adult migraine patients. Also the platelets' capacity to produce TxB2was reduced in migraine children and in adults with classic migraine. The decreased platelet TxA2synthesis in the attack‐free period of migraine patients may reflect a deficient pool of platelet arachidonic acid, the precursor of TxA2, perhaps as a result of increased consumption during migraine atta

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1984.hed2406339.x

出版商:Blackwell Science Inc    

年代:1984

数据来源: WILEY

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1984.hed2406342.x

出版商:Blackwell Science Inc    

年代:1984

数据来源: WILEY