[Current opinions on migraine pathophysiology].

Headache is one of the most common medical complaints of civilized humans; migraine, according to the IHS classification, is most often a primary episodic headache disorder. The pathophysiology of migraine is still unclear. The authors reviewed the literature and discussed mechanisms of pain, aura and other migraine symptoms. The last century has brought the shift from the vascular theory (that cranial vessels are the prime movers of the disorder) to a more integrated neurovascular theory, which takes the view that vascular change is secondary to neural activation. The most current concept of migraine pathophysiology describes migraine as a manifestation of the hereditary or predisposed sensitivity of neurovascular reaction to certain stimuli or to cyclic changes in the central nervous system. The initiation of migraine attack involves primary CNS dysfunction with subsequent activation of the trigeminovascular system. In this complex reaction a variety of biochemical factors take place. Detailed studies of this pathological pathway enable proper treatment methods to be applied.