Naslov
Vasomotor headaches

Autori
Sepčić, Juraj ; Šepić-Grahovac Dubravka ; Milohanović, Severin

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, stručni

Izvornik
Abstracts. 29th International Neuropsychiatric Symposium in Pula. Neurologija, Vol. 38, Suppl. 1 / Barac Boško, Lechner Helmut - Zagreb : Kuratorium der 29. Internationalen Neuropsychiatrischen Gerald-Grinschgl-Symposium in Pula, 1989, 10-11

Skup
29th International Neuropsychiatric Symposium in Pula

Mjesto i datum
Pula, Hrvatska, 22.05.1989. - 27.05.1989

Vrsta sudjelovanja
Pozvano predavanje

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
Vasomotor headache

Sažetak
According to the most recent classification, vasomotor headaches are divided into primary and secondary (systemic) groups. The former one comprises migraine and cluster headaches, while toxic and metabolic vascular headaches are included in the latter. Among headaches, vascular ones are the most frequent. The basic clinical criterion for migraine, the common and the accompanied one, is one-sided, or more frequently, bilateral headache. It is a headache of childhood and juvenile age manifested by onsets of variable intensity, frequency and duration, being associated with vegetative disorders. It is very often of a familial character. Simplified pathophysiologic interpretation of migraine describes this headache as a vasomotor disorder with the initial phase of vasoconstriction accompanied by vasodilatation. Accompanying phenomena of migraine attack such as scintillating scotoma, visual field deficits, paresthesias, aphasias and others correspond to the first phase. The onset and the evolution of these accompanying phenomena are very indicative for the diagnosis of migraine. However, this usual sequence of events and the evolution of onsets are not always present with migraine, thus causing the occurrence of atypical forms of headache which require diagnostic caution. Together with hereditary factors, psychical characteristics of the patient, and especially the inclination to repression of aggressiveness, are the important part of the so-called "migrainous terrain". Contribution of allergic and hormonal component is less involved. The target of ergot alkaloids and nonspecific analgetics, which are most frequently used in the therapy of migraine onset, is to reduce the intensity and duration of the crisis itself. Caffeine, sedatives and antiemetics are useful helpers. As a rule, these drugs are to be administered strictly individually in optimal doses at the very commencement of the onset. In case of frequent, severe attacs of migraine it is necessary to prevent crisis with maintenance treatment. Hygienic and dietetic measures, and hormonal therapy are of less effect. Trial tests suggest the efficacy of pizotiphen, oxetorone, methysergide, flunarizine and beta-blockers (propranolol especially). Some other drugs such as amitriptyline, can be used, but with variable success. Cluster headache is a severe, intermittent headache of exclusively hemicranial, most frequently periocular, localization. This headache characterized by periods of everyday, predominantly repeated occurrences during night, and with the accompanied homolateral autonomous symptomatology. Headaches are exchanged with asymptomatic intervals of indefinable duration. Pathophysiology of headache has not been defined yet. Clear clinical feature of a cluster headache does not require additional treatment. Treatment with methysergide, alone or in combination with other anti-migraine drugs and/or corticosteroids leads to a relative success. The treatment has to be adapted to episodic or to chronic form of the disease. Secondary (systemic) vascular headaches are caused by febricity, ingestion of chemical substances and metabolic disorders. They can occur during the syndrome of abstinence from certain dependences of drugs. Along with vasodilatation, brain edema also contributes to the appearance of headache.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

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