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Related Experiment Videos

The cluster diathesis.

M J Gawel1, A Krajewski, Y M Luo

  • 1Department of Neurology, Sunnybrook Health Science Centre, Toronto, Ontario, Canada.

Headache
|October 1, 1990
PubMed
Summary
This summary is machine-generated.

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Cluster headaches involve impaired sympathetic control of the anterior cerebral artery (ACA). This study found reduced ACA CO2 reactivity during cluster periods, suggesting a link to cavernous sinus abnormalities.

Area of Science:

  • Neurology
  • Vascular Biology
  • Pain Medicine

Background:

  • Cluster headache is a debilitating neurological disorder characterized by severe unilateral head pain.
  • The pathophysiology of cluster headache is not fully understood, but autonomic dysfunction is suspected.
  • Previous research suggests a role for the sympathetic nervous system in vasomotor control during cluster periods.

Purpose of the Study:

  • To investigate sympathetic vasomotor control of the anterior cerebral artery (ACA) in patients with cluster headaches.
  • To assess the CO2 reactivity of intracranial vessels during and outside of cluster headache periods.
  • To explore potential correlations between vascular changes and imaging findings in the cavernous sinus region.

Main Methods:

  • Transcranial Doppler (TCD) was used to measure CO2 reactivity in 119 cluster headache patients.

Related Experiment Videos

  • Vascular measurements were taken both during active cluster periods and in remission.
  • Gallium single-photon emission computerized tomography (SPECT) was performed on a subset of patients during active cluster periods.

    • Main Results:

    • ACA CO2 reactivity was significantly reduced during cluster periods, specifically on the side of the headache.
    • This diminished reactivity was observed consistently in patients studied over a full cluster cycle.
    • SPECT imaging revealed transient lesions in the cavernous sinus region in 3 out of 6 patients during active cluster periods.

    Conclusions:

    • Evidence supports a sympathetic defect in vasomotor control of the ACA during cluster headache attacks.
    • The observed ACA CO2 reactivity changes may be linked to a lesion in the cavernous sinus plexus.
    • Dysregulation of sympathetic outflow at the cavernous sinus could underlie the vascular abnormalities seen in cluster headache.