Neurogenic Vascular Responses in the Dura Mater and their Relevance for the Pathophysiology of Headaches

摘要: Abstract Neurogenic inflammation of the dura mater encephali is considered to be involved in generation primary vascular headaches. Different components neurogenic – increased blood flow and permeability, activation endothelial mast cells seem have differential significance pathophysiology While release vasoactive substances from sensory neurons, endothelium, or has clearly been shown occur during headache attacks, permeability changes not play any role. Clinical experimental observations indicate that neuropeptide calcitonin gene-related peptide (CGRP) a key position meningeal vasodilatation. Beside its direct vasorelaxant effect, CGRP releases inflammatory mediator histamine interacts with another potent vasodilator, nitric oxide, originating mainly dural cells. Parasympathetic nerve fibers are also activated some types headaches, possibly by trigeminal-parasympathetic reflex involving brain stem mechanisms. Interactions between different regulators may contribute pathogenesis