Functional brain imaging in hemicrania continua: Implications for nosology and pathophysiology

Matharu, Manjit; Goadsby, Peter J.

doi:10.1007/s11916-005-0038-z

Cited by 32 publications

(17 citation statements)

References 77 publications

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“…Summary of current functional imaging studies in different forms of trigeminal autonomic headache syndromes [22, 87, 88, 90–92, 95–97]…”

Section: Neuroimaging In Trigeminal Autonomic Cephalalgiasmentioning

confidence: 99%

A review of diagnostic and functional imaging in headache

May

2006

J Headache Pain

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The neuroimaging of headache patients has revolutionised our understanding of the pathophysiology of primary headaches and provided unique insights into these syndromes. Modern imaging studies point, together with the clinical picture, towards a central triggering cause. The early functional imaging work using positron emission tomography shed light on the genesis of some syndromes, and has recently been refined, implying that the observed activation in migraine (brainstem) and in several trigeminal-autonomic headaches (hypothalamic grey) is involved in the pain process in either a permissive or triggering manner rather than simply as a response to first-division nociception per se. Using the advanced method of voxel-based morphometry, it has been suggested that there is a correlation between the brain area activated specifically in acute cluster headache — the posterior hypothalamic grey matter — and an increase in grey matter in the same region. No structural changes have been found for migraine and medication overuse headache, whereas patients with chronic tension-type headache demonstrated a significant grey matter decrease in regions known to be involved in pain processing. Modern neuroimaging thus clearly suggests that most primary headache syndromes are predominantly driven from the brain, activating the trigeminovascular reflex and needing therapeutics that act on both sides: centrally and peripherally.

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“…Summary of current functional imaging studies in different forms of trigeminal autonomic headache syndromes [22, 87, 88, 90–92, 95–97]…”

Section: Neuroimaging In Trigeminal Autonomic Cephalalgiasmentioning

confidence: 99%

A review of diagnostic and functional imaging in headache

May

2006

J Headache Pain

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“…The clinical manifestation of HC overlaps with that of others trigeminal autonomic headaches and migraine in which activations in the hypothalamus and dorsal rostral pons, respectively, have been postulated to play important pathophysiologic roles 13–17 …”

mentioning

confidence: 99%

Hemicrania Continua Secondary to an Ipsilateral Brainstem Lesion

Valênça¹,

Andrade-Valença²,

Silva³

et al. 2007

Headache

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We describe a 47-year-old woman with a 3-year history of a continuum mild-moderate right-side headache, with exacerbations, associated with stabbing volleys of pain on right orbit-temporal region (10/10) and right eye ptosis and lacrimation with conjunctival injection. The pain was completely abolished with indomethacin (100 mg per day). The diagnosis of hemicrania continua was made according to the International Headache Society (IHS) criteria. The headache presentation was precipitated by a stroke and a right-side brainstem lesion was present at magnetic resonance imaging. This case report shows anatomoclinical evidence of the involvement of brainstem structures on the pathophysiology of hemicrania continua.

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“…The direct inhibition of trigeminocervical complex or the modulations of neurons that regulate sensory input have been proposed as possible mechanisms for topiramate's preventive action in these headache types. 11,12 According to our findings, topiramate would be an interesting alternative option in patients with HC who have contraindication or intolerance to indomethacin. However, the result shown by the patient in the present study needs to be confirmed by larger controlled clinical trials and other case series.…”

Section: Discussionmentioning

confidence: 70%

Hemicrania Continua Responsive to Topiramate: Case Report

Milanlıoğlu¹

2012

Turkiye Klinikleri J Med Sci

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emicrania continua (HC) is a relatively rare and under-recognized primary headache disorder characterized by a continuous, unilateral, moderate to severe headache that occurs in association with ipsilateral cranial autonomic features.The exacerbations are often associated with ipsilateral cranial autonomic features including conjunctival injection, ptosis, eyelid edema, lacrimation, nasal congestion and rhinorrhea. Response to indomethacin is one of the current diagnostic criteria. The complete response to therapeutic Turkiye Klinikleri J Med Sci 2012;32(4)

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Functional brain imaging in hemicrania continua: Implications for nosology and pathophysiology

Cited by 32 publications

References 77 publications

A review of diagnostic and functional imaging in headache

A review of diagnostic and functional imaging in headache

Hemicrania Continua Secondary to an Ipsilateral Brainstem Lesion

Hemicrania Continua Responsive to Topiramate: Case Report

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