Pathophysiology Of Headaches

This book provides a detailed overview of the current state of knowledge regarding the pathophysiology of both primary headaches – migraine, tension-type headache (TTH), and cluster headache – and the very important and frequent type of secondary headache, medication overuse headache (MOH). After an introductory chapter describing relevant neuroanatomy and vascular anatomy, the evidence gained from animal models regarding the pathophysiology of migraine and the other primary headaches is reviewed. Knowledge of the genetic component in the different types of headache is then examined with reference to recent evidence, for example regarding the implication of the trigeminovascular system and cortical spreading depression in migraine. Detailed information is provided on insights into primary headaches from imaging studies, including functional magnetic resonance imaging and positron emission tomography and on their neurophysiology and biochemistry. A further series of important chapters describe present knowledge of the pathophysiology of each specific type of headache and consider future directions. Written by acknowledged experts in their fields from Europe and the United States, clinicians and students will find Pathophysiology of Headaches to be an excellent source of up-to-date information on why patients experience headaches. In addition, it will be of value for pain researchers investigating the underlying mechanisms of headache.

This book provides a detailed overview of the current state of knowledge regarding the pathophysiology of both primary headaches - migraine, tension-type headache (TTH), and cluster headache - and the very important and frequent type of secondary headache, medication overuse headache (MOH). After an introductory chapter describing relevant neuroanatomy and vascular anatomy, the evidence gained from animal models regarding the pathophysiology of migraine and the other primary headaches is reviewed. Knowledge of the genetic component in the different types of headache is then examined with reference to recent evidence, for example regarding the implication of the trigeminovascular system and cortical spreading depression in migraine. Detailed information is provided on insights into primary headaches from imaging studies, including functional magnetic resonance imaging and positron emission tomography and on their neurophysiology and biochemistry. A further series of important chapters describe present knowledge of the pathophysiology of each specific type of headache and consider future directions. Written by acknowledged experts in their fields from Europe and the United States, clinicians and students will find Pathophysiology of Headaches to be an excellent source of up-to-date information on why patients experience headaches. In addition, it will be of value for pain researchers investigating the underlying mechanisms of headache.

The brain is the most complex organ in our body. Indeed, it is perhaps the most complex structure we have ever encountered in nature. Both structurally and functionally, there are many peculiarities that differentiate the brain from all other organs. The brain is our connection to the world around us and by governing nervous system and higher function, any disturbance induces severe neurological and psychiatric disorders that can have a devastating effect on quality of life. Our understanding of the physiology and biochemistry of the brain has improved dramatically in the last two decades. In particular, the critical role of cations, including magnesium, has become evident, even if incompletely understood at a mechanistic level. The exact role and regulation of magnesium, in particular, remains elusive, largely because intracellular levels are so difficult to routinely quantify. Nonetheless, the importance of magnesium to normal central nervous system activity is self-evident given the complicated homeostatic mechanisms that maintain the concentration of this cation within strict limits essential for normal physiology and metabolism. There is also considerable accumulating evidence to suggest alterations to some brain functions in both normal and pathological conditions may be linked to alterations in local magnesium concentration. This book, containing chapters written by some of the foremost experts in the field of magnesium research, brings together the latest in experimental and clinical magnesium research as it relates to the central nervous system. It offers a complete and updated view of magnesiums involvement in central nervous system function and in so doing, brings together two main pillars of contemporary neuroscience research, namely providing an explanation for the molecular mechanisms involved in brain function, and emphasizing the connections between the molecular changes and behavior. It is the untiring efforts of those magnesium researchers who have dedicated their lives to unraveling the mysteries of magnesiums role in biological systems that has inspired the collation of this volume of work.

M. WILKINSON Patients with frequent or daily headaches pose a very difficult problem for the physician who has to treat them, particularly as many patients think that there should be a medicine or medicines which give them instant relief. In the search for the compound which would meet this very natural desire, many drugs have been manufactured and the temptation for the physician is either to increase the dose of a drug which seems to be, at any rate, partially effective, or to add one or more drugs to those which the patient is already taking. Although there have been some references to the dangers of overdosage of drugs for migraine in the past, it was not until relatively recently that it was recognized that drugs given for the relief of headache, if taken injudiciously, may themselves cause headache. The first drugs to be implicated in this way were ergotamine and phenazone. In the case of ergotamine tartrate, the dangers of ergotism were well known as this was a disorder which had been known and written about for many years. In the treatment of headache, fully blown ergotism is rare and in recent years has usually been due to self-medication in doses much greater than those prescribed although there are a few recorded cases where toxic amounts have been given.

Migraine: Manifestations, Pathophysiology, and Management, Second Edition, is a much expanded, updated monograph that focuses in detail on migraine's diverse variations, its pathophysiology, and its treatment. Authored by a clinician/scientist who himself suffers from migraine, the book's premise is that the clinical significance of migraine and its treatment are intelligible only if the physician understands the anatomical, physiological, and pharmacological factors underlying both head pain and the other manifestations of migraine. The book provides clear clinical descriptions of the myriad of specific migraine syndromes, and discusses the rationale for, and elements of, a sensitive, inclusive patient history. Also covered are important but sometimes ignored topics such as environmental triggering of migraine and myofascial syndromes. The Second Edition also bridges the gap between basic science and clinical practice by explaining those substantive advances made in understanding fundamental mechanisms of head pain and aura. Recent knowledge about genetics, hormonal changes, cerebral circulation, nitric oxide, peptides, central sensitization of trigeminal neurons, and the role of periaqueductal gray matter buttress the discussion of basic mechanisms. On the treatment side, the Second Edition reflects the impressive advances in pharmacological approaches to migraine. There is a greatly expanded section on the triptans and their mechanisms of action, and rationales and practical information about the use of all other viable anti-migraine and prophylactic drugs. Psychobiological aspects of stress and stress management, elimination of environmental stimuli, the educational facets of management, and aspects of the patient/physician interaction so crucial in the treatment of migraine are all discussed. Special problems associated with the care of women, children, the elderly, patients with intractable headaches, and emergency department patients are thoroughly reviewed. In sum, this scholarly, well-referenced book offers in one volume a comprehensive scientific and clinical discussion of migraine headache.

The first textbook covering physical therapy as well as physical medicine aspects of these two highly prevalent headache disorders from both a clinical and evidence-based perspective. Written and contributed by international experts, Tension-Type and Cervicogenic Headache: Pathophysiology, Diagnosis, and Management provides the best current evidence on the pathophysiology, diagnosis, and management of patients with the highly prevalent tension type and cervicogenic headache, integrating the most recent clinical research data with basic science knowledge. It covers both physical therapy and phy

The authors of the first edition worked together again to revise data for the second edition of this popular volume. Based at three of the world's leading centers for the study and treatment of headache, these experts share their insights on every aspect of this common and irritating condition. In particular, the sections on migraine, cluster headache and vascular disease have been updated. Based on the classification system developed by the International Headache Society, Headache in Clinical Practice provides those interested in headache with an up-to-date compendium of current opinion, from epidemiology, pathophysiology and investigation, through options for intervention and management.