Neurological Sciences

, Volume 27, Supplement 2, pp s86-s90

First online:

From spreading depression to the trigeminovascular system

  • T. DalkaraAffiliated withDepartment of Neurology, Faculty of Medicine, Hacettepe University
  • , N. T. ZervasAffiliated withDepartment of Neurosurgery, Massachusetts General Hospital, Harvard Medical School
  • , M. A. MoskowitzAffiliated withDepartment of Radiology, Massachusetts General Hospital Email author 

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Migraine headaches have a complex pathophysiology; both vascular and neuronal mechanisms have been proposed. One possible scenario begins with brain-initiated events evolving to cortical spreading depression (CSD), which in turn activates the trigeminal nerve to cause headaches. Experimental evidence supports a relationship between CSD as a cause of migraine aura as well as CSD as a cause of trigeminal activation. Susceptibility to CSD and to migraine appears to be genetically determined. In some migraine subtypes, genes controlling translocation of calcium, sodium and potassium have been implicated, perhaps altering the susceptibility to CSD. This chapter briefly reviews current knowledge pertaining to migraine pathophysiology with emphasis on current notions linking disturbances in ion flux to the genesis of headache.

Key words

Migraine Physiopathology Trigeminal nerve Neurogenic inflammation Spreading depression