Pathophysiologie von Kopfschmerzerkrankungen

Abstract

Pathophysiological concepts of primary headache diseases have been developed significantly in the last decades. Nevertheless pathophysiology of single diseases is unexplained. Migraine headache arises from activation and sensibilization of trigeminal nociceptors, essential processes are located at the meninges and the meningeal vessels. Calcitonin gene-related peptide (CGRP) seems to have essential importance concerning migraine and cluster headache. Mechanisms leading to peripheral and central sensitization are relevant in chronification of migraine and tension-type headache. As a higher-level centre the hypothalamus seems to have an essential meaning in the initiation of migraine attacks. Dysbalance between the sympathetic and parasympathetic neural system causes cranial-autonomic symptoms in some headache diseases and can be affected therapeutically.

Die Pathophysiologie der primären Kopfschmerzerkrankungen wird zunehmend besser verstanden. In Bezug auf ihre Pathomechanismen scheinen die Erkrankungen wesentlich mehr Gemeinsamkeiten aufzuweisen, als noch vor einigen Jahren angenommen wurde. Gleichwohl gibt es für die einzelnen Kopfschmerzerkrankungen verschiedene pathophysiologische Konzepte, die zum einen die Kopfschmerzen und zum anderen die klinische Begleitsymptomatik erklären.

Schlüsselwörter

Pathophysiologie - trigeminale Nozizeptoren - Neurotransmitter - CGRP - neurogene Entzündung

Key words

pathophysiology - trigeminal nociceptors - neurotransmitter - CGRP - neurogenetic inflammation

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