ympathetic outflow, thus providing the anatomical basis for the expression of trigeminal pain and ipsilateral autonomic symptoms in cluster headache.Р发病机理РFigure 2. Schematic showing the pathogenesis of cluster headache. From Silberstein et al. Headache in Clinical Practice. St. Louis, Mo: Mosby-Yearbook, Inc;1998. Reproduced with permission.Р发病机理РAnatomy of cluster headache. The hypothalamus is activated and this turns on the trigeminal nerve and autonomic systems. The trigeminal nerve activation leads to pain in and around the eye. The autonomic system activation leads to eye tearing and nasal discharge that occur during a cluster headache. For surgical treatment gamma knife radiosurgery injures the trigeminal nerve. In deep brain stimulation a stimulator is placed into the hypothalamus.
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