Hardebo J E
Department of Medical Cell Research, University of Lund, Sweden.
Headache. 1991 Feb;31(2):91-106. doi: 10.1111/j.1526-4610.1991.hed3102091.x.
Various possible pathophysiological mechanisms to explain the pain in cluster headache are reviewed. Several locations for the initiation of pain along the primary afferent pathways in cranial nerves are discussed, together with the local mechanisms that might be responsible. These include neurogenic inflammation of large cranial vessels, irritation of vascular pain fibres by compression of dilated vessels in bony canals, and irritative foci in or around cranial sensory ganglia. In particular, recent neuroanatomical and pharmacological findings on nociceptive innervation of the intracranial segment of the internal carotid artery are commented upon. The possibilities for referred pain to explain the location of pain is illustrated. Evidence for involvement of central pain modulatory systems in the pain production is discussed. Finally a synthesis is made of the probable peripheral and central pain mechanisms in the disease.
本文综述了多种可能解释丛集性头痛疼痛的病理生理机制。讨论了沿颅神经初级传入通路疼痛起始的几个部位，以及可能与之相关的局部机制。这些机制包括大的颅血管的神经源性炎症、骨管中扩张血管受压对血管痛觉纤维的刺激，以及颅感觉神经节内或其周围的刺激性病灶。特别评论了近期关于颈内动脉颅内段伤害性神经支配的神经解剖学和药理学研究结果。阐述了牵涉痛解释疼痛部位的可能性。讨论了中枢疼痛调节系统参与疼痛产生的证据。最后综合阐述了该病可能的外周和中枢疼痛机制。
