Gaul Charly, Meßlinger Karl, Holle-Lee Dagny, Neeb Lars
Dtsch Med Wochenschr. 2017 Mar;142(6):402-408. doi: 10.1055/s-0042-111694. Epub 2017 Mar 22.
Pathophysiological concepts of primary headache diseases have been developed significantly in the last decades. Nevertheless pathophysiology of single diseases is unexplained. Migraine headache arises from activation and sensibilization of trigeminal nociceptors, essential processes are located at the meninges and the meningeal vessels. Calcitonin gene-related peptide (CGRP) seems to have essential importance concerning migraine and cluster headache. Mechanisms leading to peripheral and central sensitization are relevant in chronification of migraine and tension-type headache. As a higher-level centre the hypothalamus seems to have an essential meaning in the initiation of migraine attacks. Dysbalance between the sympathetic and parasympathetic neural system causes cranial-autonomic symptoms in some headache diseases and can be affected therapeutically.
在过去几十年中，原发性头痛疾病的病理生理概念有了显著发展。然而，单一疾病的病理生理学仍无法解释。偏头痛源于三叉神经伤害感受器的激活和致敏，关键过程位于脑膜和脑膜血管。降钙素基因相关肽（CGRP）似乎在偏头痛和丛集性头痛中至关重要。导致外周和中枢致敏的机制与偏头痛和紧张型头痛的慢性化有关。作为一个高级中枢，下丘脑似乎在偏头痛发作的起始中具有重要意义。交感神经系统和副交感神经系统之间的失衡在某些头痛疾病中导致颅自主神经症状，并且可以通过治疗加以影响。
