Avtor/Urednik		Vodušek, David B
Naslov		Nevrofiziološki vidiki glavobolov
Prevedeni naslov		Neurophysiology of headache
Tip		članek
Vir		Med Razgl
Vol. in št.		Letnik 38, št. Suppl 4
Leto izdaje		1999
Obseg		str. 69-82
Jezik		slo
Abstrakt		Contemporary views on migraine, cluster headache and tension-type headache are presented. The pain as the primary clinical problem in chronic headache syndromes can be a consequence of irritation of either extraor intra-cranial structures (the later being especially located at the cranial base). Such irritation readily explains the various symptomatic headaches; it is also thought to be thesource of pain in migraine and cluster headache, originating from a neurogenic inflammatory response mediated through the trigeminovascular system. In periodic tension-type headachte the pain is supposedly originating from irritated extracranial structures during physically or pshychologically stressful situations; in the chronic variety the repeated episodes of pain are thought to derange the pain modulatory systems in the brain, thus leading to pain chronification. Our knowledge of the pathophysiology of headache is still only fragmentary, and research has not yet yielded any diagnostic procedure, which would help support a clinical diagnosis of a primary headache syndrome. Research based on pathophysiological insights has, however, already led to development of new drugs.
Izvleček		V prispevku so strnjeni sodobni pogledi na nastanek glavnih primarnih glavobolov, to je migrene, glavobola tenzijskega tipa in glavobola v rafalih. Bolečina kot osnovna komponenta glavobolnih sindromov lahko nastane zaradidraženja zunajlobanjskih in nekaterih znotrajlobanjskih struktur, ki so predvsem na bazi lobanje. Medtem ko je nastanek simptomatskih glavobolov s tako razlago praviloma pojasnjen, bi naj tudi pri migreni in glavobolu v rafalih prišlo do znotrajlobanjskega izvora bolečine, in sicer zaradi sterilnega (nevrogenega) vnetnega odziva trigeminovaskularnega sistema. Pri glavobolu tenzijskega tipa bi naj šlo za akutno vzdraženje ekstrakranialnih struktur ob stresnih situacijah, kar bi se ob ponvljanju utrdilo prek sprememb v odzivnosti mehanizmov za modulacijo bolečine. Raziskovalna dognanja so zaenkrat odstrnila le posamezne procese v sklopu bolezenskega dogajanja pri obravnavanih primerih glavobolih, kar še ne zadošča za uporabo v natančnejši laboratorijski diagnostiki teh sindromov. So pa raziskave že dale koristne pobude za razvoj zdravil.
Deskriptorji		HEADACHE MIGRAINE TENSION HEADACHE