Cluster Headache
Headache
Vascular Headaches
Headache Disorders
Tension-Type Headache
Migraine Disorders
Sumatriptan
Trigeminal Autonomic Cephalalgias
Headache Disorders, Primary
Pterygopalatine Fossa
Trigeminal Nerve
Migraine with Aura
Spinal Nerves
Migraine without Aura
Paroxysmal Hemicrania
Headache Disorders, Secondary
Anisocoria
Cluster Analysis
Trigeminal Caudal Nucleus
Miosis
The trigeminovascular system in humans: pathophysiologic implications for primary headache syndromes of the neural influences on the cerebral circulation. (1/129)
Primary headache syndromes, such as cluster headache and migraine, are widely described as vascular headaches, although considerable clinical evidence suggests that both are primarily driven from the brain. The shared anatomical and physiologic substrate for both of these clinical problems is the neural innervation of the cranial circulation. Functional imaging with positron emission tomography has shed light on the genesis of both syndromes, documenting activation in the midbrain and pons in migraine and in the hypothalamic gray in cluster headache. These areas are involved in the pain process in a permissive or triggering manner rather than as a response to first-division nociceptive pain impulses. In a positron emission tomography study in cluster headache, however, activation in the region of the major basal arteries was observed. This is likely to result from vasodilation of these vessels during the acute pain attack as opposed to the rest state in cluster headache, and represents the first convincing activation of neural vasodilator mechanisms in humans. The observation of vasodilation was also made in an experimental trigeminal pain study, which concluded that the observed dilation of these vessels in trigeminal pain is not inherent to a specific headache syndrome, but rather is a feature of the trigeminal neural innervation of the cranial circulation. Clinical and animal data suggest that the observed vasodilation is, in part, an effect of a trigeminoparasympathetic reflex. The data presented here review these developments in the physiology of the trigeminovascular system, which demand renewed consideration of the neural influences at work in many primary headaches and, thus, further consideration of the physiology of the neural innervation of the cranial circulation. We take the view that the known physiologic and pathophysiologic mechanisms of the systems involved dictate that these disorders should be collectively regarded as neurovascular headaches to emphasize the interaction between nerves and vessels, which is the underlying characteristic of these syndromes. Moreover, the syndromes can be understood only by a detailed study of the cerebrovascular physiologic mechanisms that underpin their expression. (+info)Cluster headache-like attack as an opening symptom of a unilateral infarction of the cervical cord: persistent anaesthesia and dysaesthesia to cold stimuli. (2/129)
A 54 year old man experienced excruciating left retro-orbital pain with lacrimation and redness of the eye representative of a cluster headache attack. This was followed by left hemiparesis with plegia of the lower limb and left Horner's syndrome. Five days later the hemiparesis recovered while the patient developed hypoanaesthesia to cold stimuli that evoked painful burning dysaesthesia on the right side below the C4 level. MRI disclosed a discrete infarct in the left lateral aspect of the cord at C2 level concomitant to a left vertebral artery thrombosis. This limited infarct and the clinical symptoms suggest a hypoperfusion in the peripheral arterial system of the left hemicord, supplied both by the anterior and posterior spinal arteries. Cluster headache-like attack and persistent dysaesthesia to cold stimuli are discussed respectively in view of the central sympathetic involvement and partial spinothalamic system dysfunction. (+info)Cluster headache-like disorder in childhood. (3/129)
This paper reviews the diagnostic features of cluster headache-like disorder and describes its presentation in childhood. Case note summaries of patients with this condition are presented in the context of a brief summary of the literature. Four patients (two girls; aged 12 to 15 years) with cluster headache-like disorder were seen over a period of four years in the paediatric neurology department of Birmingham Children's Hospital. Their histories and clinical courses are described. All had a history of "thrashing around" or bizarre behaviour during attacks, which had distracted attention from the headache and seemed to contribute to delay in diagnosis. It appears that cluster headache-like disorder does occur in childhood but is not common and can be mistaken for other conditions. A history of thrashing around accompanied by headache is very suggestive. Recognition of the symptoms in the general paediatric clinic would allow rapid diagnosis. (+info)Cluster-tic syndrome: report of five new cases. (4/129)
The so-called short lasting primary headaches include heterogenic entities that can be divided between those without pronounced autonomic activation and those where this activation is evident, which includes the cluster-tic syndrome. We report five new cases with age closer to the trigeminal neuralgia's one, and concomitance of cluster headache and trigeminal neuralgia, which is less frequent in the literature. We also discuss briefly the pathophysiology of these clinical entities, suggesting that the trigeminus nerve is a common pathway of pain manifestation. (+info)Cluster headache in women: clinical characteristics and comparison with cluster headache in men. (5/129)
OBJECTIVE: To study the clinical characteristics of cluster headache in women. Cluster headache is a disorder of men (male to female ratio 6-7:1). METHODS: Retrospective chart review to identify all women diagnosed with cluster headache at an academic headache centre from January 1995 through July 1998. RESULTS: Thirty two women and 69 men were identified. The mean age of onset of cluster headache was 29.4 years in women versus 31.3 years in men. Two peaks of onset in women (2nd and 5th decade) were identified compared with one in men (3rd decade). Episodic cluster headache was present in 75% of women and 77% of men. Women and men had on average 3 attacks a day, but attack duration was shorter in women (67.2 minutes v 88.2 minutes). Cluster headache period duration (11.1 weeks v 10 weeks) and remission periods (21.1 months v 23.1 months) were similar in women and men. Miosis and ptosis seemed to be less common in women (miosis 13.3% v 24.6%, ptosis 41.9% v 58.1%) whereas lacrimation and nasal congestion/rhinorrhoea were almost equally prevalent in women and men. Women had more nausea than men (62.5% v 43.5%, p=0.09) and significantly more vomiting (46.9% v 17.4%, p=0.003). Photophobia occurred in 75% of women and 81.2% of men, and phonophobia occurred in 50% of women and 47.8% of men. CONCLUSIONS: The clinical characteristics of cluster headache in women are very similar to those in men. Women develop the disorder at an earlier age of onset and experience more "migrainous symptoms" with cluster headache, especially vomiting. Both men and women have frequent photophobia and phonophobia with cluster headache attacks. These symptoms are not included in the International Headache Society cluster headache criteria, suggesting the need for possible criteria revision. (+info)Management of primary headache: serendipity and science. (6/129)
Most patients find some relief with current agents, even though a poor understanding of the causes of chronic primary headache limits prophylaxis and treatment. The author reviews current preventive and treatment strategies for migraine, chronic tension headache, cluster headache, and substance withdrawal headache. (+info)Episodic paroxysmal hemicrania with seasonal variation: case report and the EPH-cluster headache continuum hypothesis. (7/129)
Episodic paroxysmal hemicrania (EPH) is a rare disorder characterized by frequent, daily attacks of short-lived, unilateral headache with accompanying ipsilateral autonomic features. EPH has attack periods which last weeks to months separated by remission intervals lasting months to years, however, a seasonal variation has never been reported in EPH. We report a new case of EPH with a clear seasonal pattern: a 32-year-old woman with a right-sided headache for 17 years. Pain occurred with a seasonal variation, with bouts lasting one month (usually in the first months of the year) and remission periods lasting around 11 months. During these periods she had headache from three to five times per day, lasting from 15 to 30 minutes, without any particular period preference. There were no precipitating or aggravating factors. Tearing and conjunctival injection accompanied ipsilaterally the pain. Previous treatments provided no pain relief. She completely responded to indomethacin 75 mg daily. After three years, the pain recurred with longer attack duration and was just relieved with prednisone. We also propose a new hypothesis: the EPH-cluster headache continuum. (+info)Persistence of attacks of cluster headache after trigeminal nerve root section. (8/129)
Cluster headache is a strictly unilateral headache that occurs in association with cranial autonomic features. We report a patient with a trigeminal nerve section who continued to have attacks. A 59-year-old man described a 14-year history of left-sided episodes of excruciating pain centred on the retro-orbital and orbital regions. These episodes lasted 1-4 h, recurring 2-3 times daily. The attacks were associated with ipsilateral ptosis, conjunctival injection, lacrimation, rhinorrhoea and facial flushing. From 1986 to 1988, he had trials of medications without any benefit. In February 1988, he had complete surgical section of the left trigeminal sensory root that shortened the attacks in length for 1 month without change in their frequency or character. In April 1988, he had further surgical exploration and the root was found to be completely excised; post-operatively, there was no change in the symptoms. From 1988 to 1999, he had a number of medications, including verapamil and indomethacin, all of which were ineffective. Prednisolone 30 mg orally daily rendered the patient completely pain free. Sumatriptan 100 mg orally and 6 mg subcutaneously aborted the attack after approximately 45 and 15 min, respectively. He was completely anaesthetic over the entire left trigeminal distribution. Left corneal reflex was absent. Motor function of the left trigeminal nerve was preserved. Neurological and physical examination was otherwise normal. MRI scan showed a marked reduction in the calibre of the left trigeminal nerve from the nerve root exit zone in the pons to Meckel's cave. An ECG-gated three-dimensional multislab MRI inflow angiogram was performed. No dilatation was observed in the left internal carotid artery during the cluster attack. Blink reflexes were elicited with a standard electrode and stimulus. Stimulation of the left supraorbital nerve produced neither ipsilateral nor contralateral blink reflex response. Stimulation of the right supraorbital nerve produced an ipsilateral response with a mean R2 onset latency of 36 ms and a contralateral response with a mean R2 onset latency of 32 ms. Lack of ipsilateral vessel dilatation makes the role of vascular factors in the initiation of cluster attacks questionable. With complete section of the left trigeminal sensory root the brain would perceive neither vasodilatation nor a peripheral neural inflammatory process; however, the patient continued to have an excellent response to sumatriptan. The case illustrates that cluster headache may be generated primarily from within the brain, and that triptans may have anti-headache effects through an entirely central mechanism. (+info)A cluster headache is a type of primary headache disorder characterized by severe, one-sided headaches that occur in clusters, meaning they happen several times a day for several weeks or months and then go into remission for a period of time. The pain of a cluster headache is typically intense and often described as a sharp, stabbing, or burning sensation around the eye or temple on one side of the head.
Cluster headaches are relatively rare, affecting fewer than 1 in 1000 people. They tend to affect men more often than women and usually start between the ages of 20 and 50. The exact cause of cluster headaches is not fully understood, but they are thought to be related to abnormalities in the hypothalamus, a part of the brain that regulates various bodily functions, including hormone production and sleep-wake cycles.
Cluster headache attacks can last from 15 minutes to several hours and may be accompanied by other symptoms such as redness or tearing of the eye, runny nose, sweating, or swelling on the affected side of the face. During a cluster period, headaches typically occur at the same time each day, often at night or in the early morning.
Cluster headaches can be treated with various medications, including triptans, oxygen therapy, and local anesthetics. Preventive treatments such as verapamil, lithium, or corticosteroids may also be used to reduce the frequency and severity of cluster headache attacks during a cluster period.
A headache is defined as pain or discomfort in the head, scalp, or neck. It can be a symptom of various underlying conditions such as stress, sinus congestion, migraine, or more serious issues like meningitis or concussion. Headaches can vary in intensity, ranging from mild to severe, and may be accompanied by other symptoms such as nausea, vomiting, or sensitivity to light and sound. There are over 150 different types of headaches, including tension headaches, cluster headaches, and sinus headaches, each with their own specific characteristics and causes.
A vascular headache is a type of headache that is primarily caused by disturbances in the blood vessels that supply blood to the brain and surrounding tissues. The two most common types of vascular headaches are migraines and cluster headaches.
Migraines are characterized by intense, throbbing pain on one or both sides of the head, often accompanied by nausea, vomiting, sensitivity to light and sound, and visual disturbances known as auras. They can last from several hours to days.
Cluster headaches, on the other hand, are characterized by severe, one-sided pain around the eye or temple that occurs in clusters, meaning they occur several times a day for weeks or months, followed by periods of remission. Cluster headaches are often accompanied by symptoms such as redness and tearing of the eye, nasal congestion, and sweating on the affected side of the face.
Other types of vascular headaches include toxic headaches caused by exposure to certain substances or drugs, and headaches associated with high blood pressure or other medical conditions that affect the blood vessels in the brain.
Headache disorders refer to a group of conditions characterized by recurrent headaches that cause significant distress and impairment in daily functioning. The most common types of headache disorders are tension-type headaches, migraines, and cluster headaches.
Tension-type headaches are typically described as a dull, aching sensation around the head and neck, often accompanied by tightness or pressure. Migraines, on the other hand, are usually characterized by moderate to severe throbbing pain on one or both sides of the head, often accompanied by nausea, vomiting, sensitivity to light and sound, and visual disturbances.
Cluster headaches are relatively rare but extremely painful, with attacks lasting from 15 minutes to three hours and occurring several times a day for weeks or months. They typically affect one side of the head and are often accompanied by symptoms such as redness and tearing of the eye, nasal congestion, and sweating on the affected side of the face.
Headache disorders can have a significant impact on quality of life, and effective treatment often requires a multidisciplinary approach that may include medication, lifestyle changes, and behavioral therapies.
A tension-type headache (TTH) is a common primary headache disorder characterized by mild to moderate, non-throbbing head pain, often described as a tight band or pressure surrounding the head. The pain typically occurs on both sides of the head and may be accompanied by symptoms such as scalp tenderness, neck stiffness, and light or sound sensitivity.
TTHs are classified into two main categories: episodic and chronic. Episodic TTHs occur less than 15 days per month, while chronic TTHs occur 15 or more days per month for at least three months. The exact cause of tension-type headaches is not fully understood, but they are believed to be related to muscle tension, stress, anxiety, and poor posture.
Treatment options for TTHs include over-the-counter pain relievers such as ibuprofen or acetaminophen, relaxation techniques, stress management, physical therapy, and lifestyle modifications. In some cases, prescription medications may be necessary to manage chronic TTHs.
A migraine disorder is a neurological condition characterized by recurrent headaches that often involve one side of the head and are accompanied by various symptoms such as nausea, vomiting, sensitivity to light and sound, and visual disturbances. Migraines can last from several hours to days and can be severely debilitating. The exact cause of migraines is not fully understood, but they are believed to result from a combination of genetic and environmental factors that affect the brain and blood vessels. There are different types of migraines, including migraine without aura, migraine with aura, chronic migraine, and others, each with its own specific set of symptoms and diagnostic criteria. Treatment typically involves a combination of lifestyle changes, medications, and behavioral therapies to manage symptoms and prevent future attacks.
Sumatriptan is a selective serotonin receptor agonist, specifically targeting the 5-HT1D and 5-HT1B receptors. It is primarily used to treat migraines and cluster headaches. Sumatriptan works by narrowing blood vessels around the brain and reducing inflammation that leads to migraine symptoms.
The medication comes in various forms, including tablets, injectables, and nasal sprays. Common side effects of sumatriptan include feelings of warmth or hotness, tingling, tightness, pressure, heaviness, pain, or burning in the neck, throat, jaw, chest, or arms.
It is important to note that sumatriptan should not be used if a patient has a history of heart disease, stroke, or uncontrolled high blood pressure. Additionally, it should not be taken within 24 hours of using another migraine medication containing ergotamine or similar drugs such as dihydroergotamine, methysergide, or caffeine-containing analgesics.
Trigeminal Autonomic Cephalalgias (TACs) is a group of primary headache disorders characterized by unilateral, severe head pain associated with ipsilateral cranial autonomic features. The International Classification of Headache Disorders, 3rd edition (ICHD-3) classifies TACs into four types:
1. Cluster Headache: Severe, strictly unilateral, orbital, supraorbital, or temporal pain lasting 15 minutes to three hours and occurring in clusters (usually at the same time of day for several weeks or months). The attacks are associated with ipsilateral cranial autonomic symptoms such as conjunctival injection, lacrimation, nasal congestion, rhinorrhea, forehead sweating, eyelid edema, and/or pupillary miosis.
2. Paroxysmal Hemicrania: Short-lasting (2-30 minutes) but recurrent attacks of severe unilateral head pain accompanied by ipsilateral cranial autonomic features. The attacks occur more than five times a day and are often associated with agitation or restlessness during the attack.
3. Short-lasting Unilateral Neuralgiform Headache Attacks (SUNHA): This category includes two subtypes: SUNCT (Short-lasting Unilateral Neuralgiform headache attacks with Conjunctival injection and Tearing) and SUNA (Short-lasting Unilateral Neuralgiform headache attacks with Autonomic symptoms). These disorders are characterized by moderate to severe unilateral head pain lasting 5 minutes to 6 hours, accompanied by cranial autonomic features.
4. Hemicrania Continua: A continuous, strictly unilateral headache of mild to moderate intensity with occasional exacerbations of severe pain. The attacks are associated with ipsilateral cranial autonomic symptoms and/or migrainous features such as photophobia, phonophobia, or nausea.
TACs are considered rare disorders, and their pathophysiology is not entirely understood. However, it is believed that they involve the trigeminal nerve and its connections to the brainstem. Treatment typically involves medications targeting the underlying mechanisms of these headaches, such as triptans for migraine-like features or anticonvulsants for neuralgiform pain. In some cases, invasive procedures like nerve blocks or neurostimulation may be considered.
Primary headache disorders are a group of headaches that are not caused by an underlying medical condition or structural problem. They are considered to be separate medical entities and include:
1. Migraine: A recurring headache that typically causes moderate to severe throbbing pain, often on one side of the head. It is commonly accompanied by nausea, vomiting, and sensitivity to light and sound.
2. Tension-type headache (TTH): The most common type of headache, characterized by a pressing or tightening sensation around the forehead or back of the head and neck. It is usually not aggravated by physical activity and does not cause nausea or vomiting.
3. Cluster headache: A rare but extremely painful type of headache that occurs in clusters, meaning they happen several times a day for weeks or months, followed by periods of remission. The pain is usually one-sided, centered around the eye and often accompanied by redness, tearing, and nasal congestion.
4. New daily persistent headache (NDPH): A type of headache that starts suddenly and persists every day for weeks or months. It can be similar to tension-type headaches or migraines but is not caused by an underlying medical condition.
5. Trigeminal autonomic cephalalgias (TACs): A group of primary headache disorders characterized by severe pain on one side of the head, often accompanied by symptoms such as redness, tearing, and nasal congestion. Cluster headaches are a type of TAC.
6. Other primary headache disorders: These include rare conditions such as hemicrania continua, paroxysmal hemicrania, and short-lasting unilateral neuralgiform headache attacks.
Primary headache disorders can significantly impact a person's quality of life and ability to function. Treatment typically involves medication, lifestyle changes, and behavioral therapies.
The pterygopalatine fossa is a small, irregularly shaped space located in the skull, lateral to the nasal cavity and inferior to the orbit. It serves as a critical communications center for several important nerves, arteries, and veins that provide sensory innervation, vasomotor control, and blood supply to various structures in the head and neck region.
The following are some key components of the pterygopalatine fossa:
1. Nerves: The pterygopalatine ganglion is a major component of this fossa, which contains postganglionic parasympathetic fibers, sympathetic fibers, and sensory fibers from various nerves, including the maxillary nerve (V2), greater petrosal nerve, deep petrosal nerve, and nerve of the pterygoid canal.
2. Arteries: The maxillary artery, a branch of the external carotid artery, enters the fossa through the foramen rotundum and divides into several branches that supply various structures in the head and neck region, such as the sphenopalatine artery, posterior superior alveolar artery, infraorbital artery, and greater palatine artery.
3. Veins: The pterygoid venous plexus is a complex network of veins located in and around the fossa that communicates with various venous systems, including the facial vein, cavernous sinus, and inferior ophthalmic vein.
The pterygopalatine fossa plays an essential role in several physiological functions, such as lacrimation, salivation, and vasodilation of blood vessels in the nasal cavity and paranasal sinuses. Additionally, it is a potential site for the spread of infection or neoplasm from the oral cavity, nasal cavity, or paranasal sinuses to other regions of the head and neck.
The trigeminal nerve, also known as the fifth cranial nerve or CNV, is a paired nerve that carries both sensory and motor information. It has three major branches: ophthalmic (V1), maxillary (V2), and mandibular (V3). The ophthalmic branch provides sensation to the forehead, eyes, and upper portion of the nose; the maxillary branch supplies sensation to the lower eyelid, cheek, nasal cavity, and upper lip; and the mandibular branch is responsible for sensation in the lower lip, chin, and parts of the oral cavity, as well as motor function to the muscles involved in chewing. The trigeminal nerve plays a crucial role in sensations of touch, pain, temperature, and pressure in the face and mouth, and it also contributes to biting, chewing, and swallowing functions.
Alkadienes are organic compounds that contain two carbon-carbon double bonds in their molecular structure. The term "alka" refers to the presence of hydrocarbons, while "diene" indicates the presence of two double bonds. These compounds can be classified as either conjugated or non-conjugated dienes based on the arrangement of the double bonds.
Conjugated dienes have their double bonds adjacent to each other, separated by a single bond, while non-conjugated dienes have at least one methylene group (-CH2-) separating the double bonds. The presence and positioning of these double bonds can significantly affect the chemical and physical properties of alkadienes, including their reactivity, stability, and spectral characteristics.
Alkadienes are important intermediates in various chemical reactions and have applications in the production of polymers, pharmaceuticals, and other industrial products. However, they can also be produced naturally by some plants and microorganisms as part of their metabolic processes.
"Migraine with Aura" is a neurological condition that is formally defined by the International Classification of Headache Disorders (ICHD) as follows:
"An migraine attack with focal neurological symptoms that usually develop gradually over 5 to 20 minutes and last for less than 60 minutes. Motor weakness is not a feature of the aura."
The symptoms of an aura may include visual disturbances such as flickering lights, zigzag lines, or blind spots; sensory disturbances such as tingling or numbness in the face, arms, or legs; and speech or language difficulties. These symptoms are caused by abnormal electrical activity in the brain and typically precede or accompany a migraine headache, although they can also occur without a headache.
It's important to note that not all people who experience migraines will have an aura, and some people may have an aura without a headache. If you are experiencing symptoms of a migraine with aura or any other type of headache, it is recommended that you consult with a healthcare professional for proper diagnosis and treatment.
Spinal nerves are the bundles of nerve fibers that transmit signals between the spinal cord and the rest of the body. There are 31 pairs of spinal nerves in the human body, which can be divided into five regions: 8 cervical, 12 thoracic, 5 lumbar, 5 sacral, and 1 coccygeal. Each spinal nerve carries both sensory information (such as touch, temperature, and pain) from the periphery to the spinal cord, and motor information (such as muscle control) from the spinal cord to the muscles and other structures in the body. Spinal nerves also contain autonomic fibers that regulate involuntary functions such as heart rate, digestion, and blood pressure.
"Migraine without Aura," also known as "Common Migraine," is defined by the International Classification of Headache Disorders (ICHD-3) as follows:
"Headaches fulfilling criteria C and D:
C. At least five attacks fulfilling criterion B
B. Headache lasting 4-72 hours (untreated or unsuccessfully treated)
1. a) Has at least two of the following characteristics:
b) One-sided location
c) Pulsating quality
d) Moderate or severe pain intensity
e) Aggravation by or causing avoidance of routine physical activity (e.g., walking or climbing stairs)
D. During headache at least one of the following:
1. a) Nausea and/or vomiting
2. b) Photophobia and phonophobia"
In simpler terms, Migraine without Aura is a recurring headache disorder characterized by moderate to severe headaches that typically occur on one side of the head, have a pulsating quality, and are aggravated by physical activity. The headaches last between 4 and 72 hours if not treated or if treatment is unsuccessful. Additionally, during the headache, at least one of the following symptoms must be present: nausea/vomiting, sensitivity to light (photophobia), or sensitivity to sound (phonophobia).
Paroxysmal Hemicrania is a rare primary headache disorder characterized by severe, unilateral (one-sided) head pain that occurs in brief, recurring episodes or attacks. The pain is usually located in the temple, eye, or face and can be accompanied by ipsilateral (same side) autonomic symptoms such as redness of the eye, tearing, nasal congestion, or sweating.
The headaches typically last between 2-30 minutes and occur several times a day, often increasing in frequency over time. The disorder predominantly affects women and tends to begin in middle age. Paroxysmal Hemicrania is considered a type of trigeminal autonomic cephalalgia (TAC) and is thought to be caused by abnormal activation of the trigeminovascular system, which supplies nerves to the head and face.
The disorder is uniquely responsive to indomethacin, a nonsteroidal anti-inflammatory drug (NSAID), with most patients experiencing complete or significant relief at doses of 150-225 mg/day. Failure to respond to indomethacin should raise suspicion for other types of headache disorders.
Tryptamines are a class of organic compounds that contain a tryptamine skeleton, which is a combination of an indole ring and a ethylamine side chain. They are commonly found in nature and can be synthesized in the lab. Some tryptamines have psychedelic properties and are used as recreational drugs, such as dimethyltryptamine (DMT) and psilocybin. Others have important roles in the human body, such as serotonin, which is a neurotransmitter that regulates mood, appetite, and sleep. Tryptamines can also be found in some plants and animals, including certain species of mushrooms, toads, and catnip.
Secondary headache disorders refer to headaches that are caused by an underlying medical condition, structural abnormality, or injury. These headaches can have various characteristics and patterns, and their symptoms may mimic those of primary headache disorders such as migraine or tension-type headaches. However, in order to diagnose a secondary headache disorder, the healthcare provider must identify and address the underlying cause.
Examples of conditions that can cause secondary headache disorders include:
* Intracranial hemorrhage (bleeding in the brain)
* Brain tumors or other space-occupying lesions
* Meningitis or encephalitis (infections of the membranes surrounding the brain or the brain itself)
* Sinusitis or other respiratory infections
* Temporomandibular joint disorder (TMJ)
* Giant cell arteritis (a condition that affects the blood vessels in the head and neck)
* Substance use or withdrawal (such as from caffeine or alcohol)
* Medications (such as nitroglycerin or blood pressure-lowering drugs)
It is important to note that secondary headache disorders can be serious and even life-threatening, so it is essential to seek medical attention if you experience a new or unusual headache, especially if it is accompanied by other symptoms such as fever, weakness, numbness, or difficulty speaking.
Anisocoria is a medical term that refers to an inequality in the size of the pupils in each eye. The pupil is the black, circular opening in the center of the iris (the colored part of the eye) that allows light to enter and strike the retina. Normally, the pupils are equal in size and react similarly when exposed to light or darkness. However, in anisocoria, one pupil is larger or smaller than the other.
Anisocoria can be caused by various factors, including neurological conditions, trauma, eye diseases, or medications that affect the pupillary reflex. In some cases, anisocoria may be a normal variant and not indicative of any underlying medical condition. However, if it is a new finding or associated with other symptoms such as pain, headache, vision changes, or decreased level of consciousness, it should be evaluated by a healthcare professional to determine the cause and appropriate treatment.
Cluster analysis is a statistical method used to group similar objects or data points together based on their characteristics or features. In medical and healthcare research, cluster analysis can be used to identify patterns or relationships within complex datasets, such as patient records or genetic information. This technique can help researchers to classify patients into distinct subgroups based on their symptoms, diagnoses, or other variables, which can inform more personalized treatment plans or public health interventions.
Cluster analysis involves several steps, including:
1. Data preparation: The researcher must first collect and clean the data, ensuring that it is complete and free from errors. This may involve removing outlier values or missing data points.
2. Distance measurement: Next, the researcher must determine how to measure the distance between each pair of data points. Common methods include Euclidean distance (the straight-line distance between two points) or Manhattan distance (the distance between two points along a grid).
3. Clustering algorithm: The researcher then applies a clustering algorithm, which groups similar data points together based on their distances from one another. Common algorithms include hierarchical clustering (which creates a tree-like structure of clusters) or k-means clustering (which assigns each data point to the nearest centroid).
4. Validation: Finally, the researcher must validate the results of the cluster analysis by evaluating the stability and robustness of the clusters. This may involve re-running the analysis with different distance measures or clustering algorithms, or comparing the results to external criteria.
Cluster analysis is a powerful tool for identifying patterns and relationships within complex datasets, but it requires careful consideration of the data preparation, distance measurement, and validation steps to ensure accurate and meaningful results.
The Trigeminal Caudal Nucleus, also known as the nucleus of the spinal trigeminal tract or spinal trigeminal nucleus, is a component of the trigeminal nerve sensory nuclear complex located in the brainstem. It is responsible for receiving and processing pain and temperature information from the face and head, particularly from the areas innervated by the ophthalmic (V1) and maxillary (V2) divisions of the trigeminal nerve. The neurons within this nucleus then project to other brainstem regions and ultimately to the thalamus, which relays this information to the cerebral cortex for conscious perception.
In medical terms, the orbit refers to the bony cavity or socket in the skull that contains and protects the eye (eyeball) and its associated structures, including muscles, nerves, blood vessels, fat, and the lacrimal gland. The orbit is made up of several bones: the frontal bone, sphenoid bone, zygomatic bone, maxilla bone, and palatine bone. These bones form a pyramid-like shape that provides protection for the eye while also allowing for a range of movements.
Miosis is the medical term for the constriction or narrowing of the pupil of the eye. It's a normal response to close up viewing, as well as a reaction to certain drugs like opioids and pilocarpine. Conversely, dilation of the pupils is called mydriasis. Miosis can be also a symptom of certain medical conditions such as Horner's syndrome or third cranial nerve palsy.
The hypothalamus is a small, vital region of the brain that lies just below the thalamus and forms part of the limbic system. It plays a crucial role in many important functions including:
1. Regulation of body temperature, hunger, thirst, fatigue, sleep, and circadian rhythms.
2. Production and regulation of hormones through its connection with the pituitary gland (the hypophysis). It controls the release of various hormones by producing releasing and inhibiting factors that regulate the anterior pituitary's function.
3. Emotional responses, behavior, and memory formation through its connections with the limbic system structures like the amygdala and hippocampus.
4. Autonomic nervous system regulation, which controls involuntary physiological functions such as heart rate, blood pressure, and digestion.
5. Regulation of the immune system by interacting with the autonomic nervous system.
Damage to the hypothalamus can lead to various disorders like diabetes insipidus, growth hormone deficiency, altered temperature regulation, sleep disturbances, and emotional or behavioral changes.
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