Review article
Migraine – pathophysiology of pain
Vlasta Vuković
orcid.org/0000-0003-4963-4541
; Department of neurology, University hospital Sestre milosrdnice, Zagreb, Croatia
Maja Strineka
Arijana Lovrenčić-Huzjan
Vida Demarin
Abstract
Migraine is a primary episodic headache disorder characterized by a cascade of events that involve various combinations of neurologic, gastrointestinal and autonomic changes. Headache is probably caused by activation of meningeal and blood vessel nociceptors combined with an alteration in central pain modulation. Headache and its associated neuro-vascular changes are subserved by the trigeminal system. A link also exists between the migraine aura and headache. Cortical spreading depression (CSD) activates trigeminovascular afferents, causing a long-lasting increase in middle meningeal arterial blood flow and polypeptide release within the dura mater. The neuropeptides interact with the blood vessel wall, producing dilatation, plasma protein extravasation, and platelet activation. Neurogenic inflammation sensitizes nerve fibers (peripheral sensitization) that now respond to previously innocuous st imuli, such as blood vessel pulsations, causing, in part, the pain of migraine.
Keywords
migraine; pathophysiology; pain
Hrčak ID:
42379
URI
Publication date:
20.10.2009.
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