Hypothalamic deep brain stimulation for intractable chronic cluster headache: A 3-year follow-up

被引:0
作者
M. Leone
A. Franzini
G. Broggi
G. Bussone
机构
[1] Headache Centre, Cerebrovascular Disease Department, C. Besta National Neurological Inst., I-20133 Milan
[2] Department of Neurosurgery, C. Besta National Neurological Inst., I-20133 Milan
关键词
Cluster headache; Deep brain stimulation; Hypothalamus; Pathophysiology; Therapy;
D O I
10.1007/s100720300063
中图分类号
学科分类号
摘要
Cluster headache is the most severe among primary headaches. Positron emission tomography and functional MRI studies have demonstrated that the ipsilateral posterior hypothalamus is activated during cluster headache attacks and is structurally asymmetric in these patients thus indicating that cluster headache may originate at that level. These hypothalamic abnormalities in cluster headache led to the suggestion that deep brain stimulation of ipsilateral posterior inferior hypothalamus might produce clinical improvement in otherwise treatment refractory chronic cluster headache patients. In a patient with severe intractable chronic cluster headache, hypothalamic electrical stimulation produced complete and long-term pain relief with no relevant side effects. So far other operations have been performed and the results are encouraging in terms of both pain relief and safety. The efficacy of hypothalamic electrical stimulation provides some hints into cluster headache pathophysiology.
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页码:S143 / S145
页数:2
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共 21 条
[1]  
Classification and diagnostic criteria for headache disorders, cranial neuralgias and facial pain. Headache classification committee of the International Headache Society, Cephalalgia, 8, SUPPL. 7, pp. 1-96, (1998)
[2]  
Goadsby P.J., Pathophysiology of cluster headache: A trigeminal autonomic cephalgia, Lancet, 1, pp. 251-257, (2002)
[3]  
Goadsby P.J., Edvinsson L., Human in vivo evidence for trigeminovascular activation in cluster headache, Brain, 117, pp. 427-434, (1994)
[4]  
Kirpatrick P.J., O'Brien M., MacCabe J.J., Trigeminal nerve section for chronic migraine neuralgia, Br. J. Neurosurg., 7, pp. 483-490, (1993)
[5]  
O'Brien M., Kirpatrick P.J., MacCabe J.J., Trigeminal nerve section for chronic migraine neuralgia, Cluster Headache and Related Conditions, pp. 291-295, (1999)
[6]  
Goadsby P.J., Lipton R.B., A review of paroxysmal hemicranias, SUNCT, syndrome and other short-lasting headaches with autonomic features, including new cases, Brain, 120, pp. 193-209, (1997)
[7]  
Kudrow L., The cyclic relationship of natural illumination to cluster period frequency, Cephalalgia, 7, SUPPL. 6, pp. 76-78, (1997)
[8]  
Russell D., Cluster headache: Severity and temporal pattern of attacks and patient activity prior to and during attacks, Cephalalgia, 1, pp. 209-216, (1981)
[9]  
Waldenlind E., Gustafsson S.A., Ekbom K., Wetterberg L., Circadian secretion of cortisol and melatonin during active cluster periods and remission, J. Neurol. Neurosurg. Psychiatry, 50, pp. 207-213, (1987)
[10]  
Leone M., Lucini V., D'Amico D., Moschiano F., Maltempo C., Fraschini F., Bussone G., Twenty-four hour melatonin and cortisol plasma levels in relation to timing of cluster headache, Cephalalgia, 15, pp. 224-229, (1995)