第十三章 头痛（The thirteenth chapter is headache）.docVIP

第十三章 头痛（The thirteenth chapter is headache） (2) the endocrine and metabolic factors: women than men prone to migraine, in female patients, menstruation or menstrual cramps occur when migraine attacks, or menopause after pregnancy to reduce or stop the attack. In some cases feeding cheese, wine and chocolate or taking reserpine and vasodilator drugs can induce migraine, migraine and 5- hydroxytryptamine (5-HT) norepinephrine, substance P and four arachidonic acid metabolic abnormalities. (3) other factors: emotional stress, head trauma, hunger, sleep disturbance, climate change and mental stimulation are all related to migraine attack. 2. pathogenesis is unknown, there are several main theories: (1) vascular theory: the traditional theory that vascular migraine aura symptoms and intracranial vascular contraction, then the intracranial and extracranial vascular expansion led to the occurrence of headache, but this theory is difficult to explain the prodromal symptoms of migraine, cerebral blood flow (CBF) results is not confirmed. (2) neurovascular Theory: the dysfunction of the hypothalamus and limbic system is related to the prodromal symptoms of migraine, and the occurrence of aura and headache is related to the secondary vascular changes after neuronal dysfunction. In the aura phase, cBF decreased from the occipital cortex, preceded by diffusion, preceded signs and continued into the headache phase, increased CBF after headache onset, and continued to a headache relief. Migraine without aura did not have similar cBF changes. The dorsal raphe nucleus of the midbrain may be a generator of migraine, associated with activation in the area and stimulation of the trigeminal nerve endings. Stimulation of the trigeminal nerve, substance P, calcitonin gene-related peptide and neurokinin A (neurokinin A) increased release can cause neurogenic inflammation and increase the sensitivity and change of microcirculation blood flow of neurons. (3) neurotransmitters: 5.HT plays an