Hannerz J, Hellström G, Klum T, Wahlgren N G
Neurological Clinic, Karolinska Hospital, Stockholm, Sweden.
Cephalalgia. 1990 Feb;10(1):31-8. doi: 10.1046/j.1468-2982.1990.1001031.x.
Nitroglycerin (NG) induces in cluster headache patients and controls an increase in systemic diastolic blood pressure and/or heart rate and a decrease in blood flow velocity in the middle cerebral artery (VMCA). Termination of NG induced cluster headache-like attack was correlated to an increase of VMCA compared to the VMCA before NG administration (p less than 0.01). This increase was not found in patients without attack or in controls. The NG induced "dynamite headache" in the controls subsided when blood pressure and heart rate were normalized, but the decrease of VMCA still prevailed. Orbital phlebograms have shown pathologic changes in cluster headache and in Tolosa-Hunt syndrome but not in controls. Ocular sympathetic nerves are involved in cluster headache but seldom in Tolosa-Hunt syndrome. It is suggested that the start of a cluster headache attack is due to an increase and the termination of the attack to a decrease of blood flow to the sympathoplegic phlebopathic cavernous sinus.
硝酸甘油（NG）可使丛集性头痛患者和对照组的全身舒张压和/或心率升高，同时使大脑中动脉血流速度（VMCA）降低。与NG给药前的VMCA相比，NG诱发的丛集性头痛样发作的终止与VMCA的增加相关（p小于0.01）。在无发作的患者或对照组中未发现这种增加。当血压和心率恢复正常时，对照组中NG诱发的“爆炸性头痛”消退，但VMCA的降低仍然存在。眼眶静脉造影显示丛集性头痛和托洛萨-亨特综合征存在病理改变，而对照组则无。眼交感神经参与丛集性头痛，但很少参与托洛萨-亨特综合征。有人提出，丛集性头痛发作的开始是由于向交感神经麻痹性静脉病变性海绵窦的血流增加，而发作的终止是由于血流减少。
