Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
Department of Neurology, University of Florida, Gainesville, Florida.
Semin Neurol. 2022 Aug;42(4):459-473. doi: 10.1055/s-0042-1757924. Epub 2022 Nov 2.
Headache disorders can produce recurrent, incapacitating pain. Migraine and cluster headache are notable for their ability to produce significant disability. The anatomy and physiology of headache disorders is fundamental to evolving treatment approaches and research priorities. Key concepts in headache mechanisms include activation and sensitization of trigeminovascular, brainstem, thalamic, and hypothalamic neurons; modulation of cortical brain regions; and activation of descending pain circuits. This review will examine the relevant anatomy of the trigeminal, brainstem, subcortical, and cortical brain regions and concepts related to the pathophysiology of migraine and cluster headache disorders.
头痛障碍可导致反复发作、使人丧失能力的疼痛。偏头痛和丛集性头痛的显著特点是它们具有导致显著残疾的能力。头痛障碍的解剖学和生理学是制定治疗方法和研究重点的基础。头痛机制的关键概念包括三叉神经血管、脑干、丘脑和下丘脑神经元的激活和敏化;皮质脑区的调制;以及下行疼痛回路的激活。本综述将检查三叉神经、脑干、皮质下和皮质脑区的相关解剖结构,以及与偏头痛和丛集性头痛障碍的病理生理学相关的概念。