Pathophysiology of CH

Annette · Pathophysiology of CH

Pathophysiology
The pathophysiology of cluster headaches is not well understood. Some proposed mechanisms are described here.

Hemodynamic: Vascular dilatation may play a role, but blood flow studies are inconsistent. Extracranial blood flow (hyperthermia and increased temporal artery blood flow) increases but following the onset of pain. Vascular change is considered secondary to primary neuronal discharge.

Trigeminal nerve: The trigeminal nerve may be responsible for neuronal discharge causing cluster headaches. Substance P neurons carry sensory and motor impulses in the maxillary and ophthalmic divisions of the nerve. These connect with the sphenopalatine ganglion and interior carotid perivascular sympathetic plexus. Somatostatin inhibits substance P and reduces the duration and intensity of cluster headaches.

Autonomic nervous system: Sympathetic (eg, Horner syndrome, forehead sweating) and parasympathetic (eg, lacrimation, rhinorrhea, nasal congestion) effects occur.

Circadian rhythm: Cluster headaches often recur at the same time every day, suggesting that the hypothalamus, which controls circadian rhythms, may be the site of activation.

Serotonin: This is not as striking as in migraines, but some changes are seen.

Histamine: Although evidence supporting a causative role is inconsistent, cluster headaches may be precipitated with small amounts of histamine. Antihistamines do not abort cluster headaches.

Mast cells: Increased numbers of mast cells have been found in the skin of painful areas of some patients, but this finding is inconsistent.

This is from

http://www.emedicine.com/emerg/byname/Headache--Cluster.htm

What is worth noting is that histamine may precipitate CH but antihistamines do not abort. What this may mean is that if you have high allergy problems, the histamines released may trigger other events leading to a CH. I believe this is why antihistamine IV infusion can help preventing CH in some people. This may also explain why allergy reactions to sinus infection, flu virus, fumes and various substances can trigger CH in some people. Therefore if you have high allergy problems, this may complicate your CH further and it should be looked at and addressed seriously.

Also there has been talk about how chiropractor, massage therapy ... can help in some isolated cases. I believe this can be explained by the inflammation reaction in the muscles and skin of the painful areas ( scalp, neck, shoulders etc ) proven by the detection of mast cells there. Mast cells are released in high quantity during an inflammatory response. If you cant afford professional treatments to help with chronic muscle tensions and inflammation then try applying heat/ice to those areas and maybe ask your supporter to give you a massage there. That will help eliminating mast cells and allowing these tissues to heal.

Ike

Wow thanx for that, im gonna read a little more about that now