Advances in understanding the pathophysiology of headache

Silberstein, Stephen D. MD

From Temple University School of Medicine, and the Comprehensive Headache Center at The Germantown Hospital and Medical Center, Philadelphia, Pennsylvania.

Address correspondence and reprint requests to Dr. Stephen D. Silberstein, One Penn Boulevard, Philadelphia, PA 19144.

Neurology 42(3):p 6-10, March 1992.

Article abstract

Recent evidence suggests that migraine may not be due to vasoconstriction followed by reactive vasodilation, and tension-type headache may not be due to excess muscle contraction. The prodromes of migraine may have a hypothalamic origin, and the aura and changes in cognition may have a cortical neuronal origin. The pain of migraine and tension-type headache may be generated centrally or enhanced or generated by neurogenic inflammation. Drugs used to treat headache frequently interact with serotonin receptor subtypes: abortive drugs at the 5-HT₁ receptor and preventive drugs at the 5-HT₂ receptor.