Estratto
Sebbene numerosi studi siano stati effettuati per indagare la patogenesi della cefalea a grappolo, non vi è ancora una univoca interpretazione sull’origine di questa cefalea primaria. In particolare manca un modello sperimentale in grado di giustificare le principali caratteristiche cliniche della cefalea a grappolo, quali la unilateralità degli attacchi, la circadianità delle crisi e la circannualità dei periodi dolorosi (i cosiddetti grappoli) nonché la predilezione per i soggetti di sesso maschile. Per quanto concerne le manifestazioni cliniche, la cefalea a grappolo si distingue nettamente dalle altre principali sindromi dolorose del capo, quali l’emicrania e la nevralgia del trigemino, che hanno difatti trattamenti farmacologici in gran parte differenti da quelli adottati per la cefalea a grappolo. Nonostante la netta demarcazione clinica di questa sindrome dolorosa del capo è stato ipotizzato che la cefalea a grappolo, l’emicrania e la nevralgia del trigemino possano avere un terreno patogenetico comune. Questo nuovo modo di interpretare la patogenesi del dolore cranio-facciale è confermato dal non infrequente riscontro nella pratica clinica di forme di passaggio tra l’una e l’altra sindrome. Allo stato attuale delle conoscenze è tuttavia necessario continuare a tenere separata la trattazione della patogenesi della cefalea a grappolo.
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Bussone, G., Usai, S. (2008). Cefalea a grappolo e TACs: dalla fisiopatologia alla terapia. In: Le cefalee: manuale teorico-pratico. Springer, Milano. https://doi.org/10.1007/978-88-470-0754-3_7
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