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Related Concept Videos

Increased Intracranial Pressure l: Introduction01:14

Increased Intracranial Pressure l: Introduction

Intracranial hypertension is a sustained elevation of intracranial pressure (ICP) above 22 mm Hg. In supine adults, normal ICP is ~7–15 mm Hg.The rigid, nonexpandable cranium contains three components—brain tissue, blood, and cerebrospinal fluid (CSF)—that total ~1,700 mL in a typical adult: 1,400 mL brain (~80%), 150 mL blood (~10%), and 150 mL CSF (~10%). According to the Monro–Kellie doctrine, total intracranial volume is effectively fixed. When one component expands, CSF and venous blood...
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Hemorrhagic Stroke l: Introduction

A hemorrhagic stroke is an acute neurological event that occurs when a weakened cerebral blood vessel ruptures, allowing blood to accumulate within or around the brain. The sudden release of blood forms a focal hematoma that increases intracranial pressure, displaces neural tissue, and can obstruct cerebrospinal fluid pathways. These effects may be compounded by intraventricular extension of the hemorrhage, cerebral edema, or compression of adjacent structures, all of which contribute to...
Increased Intracranial Pressure ll: Pathophysiology01:29

Increased Intracranial Pressure ll: Pathophysiology

Increased intracranial pressure (ICP) refers to a potentially life-threatening rise in pressure inside the skull. This usually happens when there is a major change in the volume of brain tissue, blood, or cerebrospinal fluid (CSF) — the three components inside the skull. According to the Monro-Kellie doctrine, if the volume of one component increases, the volumes of the other components must decrease to maintain normal pressure. If this does not happen, ICP rises.The process often begins with...
Angle Closure Glaucoma: Treatment01:28

Angle Closure Glaucoma: Treatment

Angle-closure glaucoma, or closed-angle glaucoma, is an eye condition where the iris bulges out and blocks the iridocorneal angle, resulting in a buildup of aqueous humor and increased intraocular pressure. Immediate medical attention is necessary due to the sudden onset of symptoms. The treatment for angle-closure glaucoma includes short-term and long-term approaches. Short-term treatment involves using eye drops like pilocarpine to lower intraocular pressure by increasing aqueous humor...
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Glaucoma: Overview

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3D-Neuronavigation In Vivo Through a Patient's Brain During a Spontaneous Migraine Headache
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Cluster headache.

Elizabeth Leroux1, Anne Ducros

  • 1Centre d'Urgences Céphalées, Hôpital Lariboisière, Paris, France. elileroux@hotmail.com

Orphanet Journal of Rare Diseases
|July 25, 2008
PubMed
Summary

Cluster headache (CH) is a severe neurological disorder causing excruciating pain and autonomic symptoms. While treatments exist to manage attacks and reduce frequency, a cure for this unpredictable condition remains elusive.

Area of Science:

  • Neurology
  • Headache Medicine

Background:

  • Cluster headache (CH) is a primary headache disorder characterized by severe unilateral orbital, supraorbital, or temporal pain.
  • Attacks are short-lasting (15-180 minutes) and accompanied by ipsilateral autonomic features, affecting young adults, predominantly males.
  • CH exhibits circadian and circannual periodicity, with attacks clustering in bouts and potential triggers including alcohol, strong odors, and napping.

Purpose of the Study:

  • To provide a comprehensive overview of cluster headache, including its clinical presentation, pathophysiology, diagnosis, and management.
  • To highlight the current understanding of CH's cyclic nature, potential genetic links, and diagnostic challenges.
  • To review existing acute and prophylactic treatment strategies and emerging experimental therapies.

Main Methods:

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  • Clinical diagnosis based on characteristic pain and autonomic symptoms.
  • Review of epidemiological data, including prevalence and familial patterns.
  • Examination of neurobiological underpinnings, including hypothalamic involvement and genetic associations (hypocretin receptor gene).
  • Assessment of current therapeutic interventions, encompassing acute treatments (sumatriptan, oxygen) and prophylactic options (verapamil, lithium, etc.).
  • Exploration of experimental treatments like deep-brain stimulation and occipital nerve stimulation.

Main Results:

  • CH affects 0.5-1.0/1,000 individuals, primarily young males, with a significant cyclic pattern.
  • Hypothalamic involvement is implicated in the periodicity of CH, though precise causative mechanisms are unknown.
  • Diagnosis is clinical, differentiating from other primary headaches like migraine and SUNCT.
  • Acute treatments include sumatriptan and oxygen; prophylactic treatments involve verapamil, lithium, and others.
  • Refractory cases may be managed with neuromodulation techniques, though prognosis remains unpredictable.

Conclusions:

  • Cluster headache is a debilitating primary headache with a distinct clinical profile and periodicity, likely involving hypothalamic dysfunction.
  • While effective acute and prophylactic treatments are available, a definitive cure is lacking, and the disease course is unpredictable.
  • Further research into genetic factors and neurobiological mechanisms is crucial for developing more targeted and curative therapies for cluster headache.