Master thesis, Other literature type
- Publisher: BMJ Publishing Group
Cluster | treatment | Book Reviews | pathophysiology | Neurological Disorders | headache
Cluster headache is the most severe primary headache with recurrent pain attacks described as worse than giving birth. The aim of this paper was to make an overview of current knowledge on cluster headache with a focus on pathophysiology and treatment. This paper presents hypotheses of cluster headache pathophysiology, current treatment options and possible future therapy approaches. For years, the hypothalamus was regarded as the key structure in cluster headache, but is now thought to be part of a more complex pain-generating network. Today a dysfunction of the descending pain-modulating system, probably including the hypothalamus, is the main hypothesis in cluster headache pathophysiology. However, recent studies on resting state networks of the brain suggest a more diffuse dysfunction of the functional connectivity, possibly due to a persistent dysfunction in the central nervous system. New therapeutic approaches as neurostimulation of the sphenopalatine ganglion and the occipital nerve are promising alternatives to standard treatment. However, there is still a need for development of new therapeutic strategies for patients with refractory headaches, and the understanding of the pathophysiology is incomplete. Thus more research in both fields is required.