Mechanisms of headache
The physiological mechanisms that produce the subjective sensation of headache include:
- skeletal muscle contraction e.g. tension headache
- arterial dilatation:
- extracranial, as in migraine
- intracranial, as in nitrate vasodilators, hypertension, systemic infections
- traction on arteries:
- raised intracranial pressure
- tumour
- haemorrhage
- traction or dilatation of venous sinuses, for example post-lumbar puncture headache
- inflammation
- extracranial, for example temporal cell arteritis
- intracranial, for example meningitis
- referred pain, for example disease of ears, sinuses, eyes, cervical spine - ankylosing spondylitis
- psychogenic
MaassenVanDenBrink A, Ibrahimi K, Edvinsson L. Intracranial and extracranial arteries in migraine. Lancet Neurol 2013; 12: 847–848.
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