Cerebral Blood Flow Studies in Patients with Cluster Headache

Nelson, Robert F.; Boulay, G. H. du; Marshall, John; Russell, Richard A.; Symon, Lindsay; Zilkha, E.

doi:10.1111/j.1526-4610.1980.hed2004184.x

Cited by 49 publications

(38 citation statements)

References 7 publications

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“…Various studies have been performed, including SPECT and xenon-133 inhalation [46][47][48], and have shown heterogeneous results, with reports of high, low, or no change in cortical blood flow. Methodologic differences probably account for these conflicting results.…”

Section: Cerebral Blood Flow Imaging and Cluster Headachesmentioning

confidence: 96%

Functional neuroimaging of primary headache disorders

Cohen¹,

Goadsby²

2004

Curr Neurol Neurosci Rep

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Until recently, primary headache disorders such as migraine and cluster headache were considered to be vascular in origin. However, advances in neuroimaging techniques, such as positron emission tomography, single photon emission computerized tomography, and functional magnetic resonance imaging, have augmented the growing clinical evidence that these headaches are primarily driven from the brain. This review covers functional imaging studies in migraine, cluster headache, rarer headache syndromes, and experimental head pain. Together with newer techniques, such as voxel-based morphometry and magnetic resonance spectrometry, functional imaging continues to play a role in elucidating and targeting the neural substrates in each of the primary headache syndromes.

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Section: Cerebral Blood Flow Imaging and Cluster Headachesmentioning

confidence: 96%

Functional neuroimaging of primary headache disorders

Cohen¹,

Goadsby²

2004

Curr Neurol Neurosci Rep

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“…Most were done with single photon emission computed tomography. The results of this semi-quantitative method have been variable, some reporting an increase, some a decrease, and some no differences in cortical blood flow, probably due to methodologic differences [35][36][37][38][39] ( Table 1). The more recent study by Di Piero et al [49] examined patients with cluster headache out of the active period and normal volunteers using the cold water pressor test.…”

Section: Single Photon Emission Computed Tomographymentioning

confidence: 99%

Hypothalamic involvement and activation in cluster headache

May

Goadsby

2001

Current Science Inc

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Cluster headache is an episodic form of primary neurovascular headache that is both severe and relatively rare. It is characterized by episodes of headache with cranial parasympathetic activation and sympathetic impairment that come in bouts, or clusters. Its pathophysiology can be divided into understanding the attack phenotype and the biotype of the periodicity. Acute attacks of cluster headache are marked by trigeminal nerve-mediated pain and with cranial autonomic activation, trigeminal-autonomic cephalalgia; an activation that characterizes the phenotype of a group of headaches. The signature feature of cluster headache is its periodicity, the daily cycle of attacks when the patient is in an active bout, or the circumannual, or other period, cycling that distinguishes the on period from the off period. Functional brain imaging with positron emission tomography and structural imaging with voxel-based morphometry have identified an area in the posterior hypothalamic gray as key in understanding cluster headache. This area is subtly enlarged in its gray matter volume, active during an acute cluster headache but inactive when patients are challenged between bouts. Cluster headache is likely to be a form of primary neurovascular pain whose phenotypic expression relies on the trigeminal-autonomic reflex, with a biotype determined by the brain area, the posterior hypothalamus, in which the lesion seems to be located. Understanding both the phenotypic expression and the biotype will, respectively, enable better acute attack treatments and better preventative management of this horrible form of headache.

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“…The increase or decrease in signal reflect changes more likely related to the timing of secondary events rather than shedding any light on the process itself [6,7].…”

Section: Discussionmentioning

confidence: 98%

History of cluster headache

Gordon

2005

Current Science Inc

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Possibly because of the manifestation of severe debilitating pain, cluster headache has been identified in early publications, described in exquisite detail by authors dating as far back as 1641. These early descriptions focused on the symptoms of the episodes rather than the periodicity of their occurrence. Similar to most medical conditions described without anatomic or clearly defined pathophysiologic basis, cluster headache often was named for its clinical manifestations, or less helpfully, by the names of the authors of its descriptive publications. It was only in 1952 that the condition was named for its peculiar tendency to occur in clusters over a period of weeks rather than being a chronic, recurrent, episodic condition similar to migraine. Despite having such an interesting mix of autonomic and physical features, this observation seems to be most instrumental in divulging the true pathogenesis of this disease and correctly localizing its origin anatomically in the hypothalamus.

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Cerebral Blood Flow Studies in Patients with Cluster Headache

Cited by 49 publications

References 7 publications

Functional neuroimaging of primary headache disorders

Functional neuroimaging of primary headache disorders

Hypothalamic involvement and activation in cluster headache

History of cluster headache

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