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1.
Cephalalgia ; 29(3): 365-72, 2009 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-19175774

RESUMO

Cytokines have been measured in cerebrospinal fluid (CSF) from headache patients [infrequent episodic tension-type headache (TTH) and migraine with or without aura, all during attack, and cervicogenic headache] and compared with levels in pain-free individuals. Both proinflammatory [interleukin (IL)-1beta, tumour necrosis factor-alpha and monocyte chemoattractant protein-1 (MCP-1)] and anti-inflammatory cytokines [IL-1 receptor antagonist (IL-1ra), IL-4, IL-10 and transforming growth factor-beta1 (TGF-beta1)] were included. There were significant group differences in IL-1ra, TGF-beta1 and MCP-1 in episodic TTH and migraine compared with controls, and a significant difference in MCP-1 between cervicogenic headache and migraine with aura. Intrathecal MCP-1 correlated with IL-1ra, IL-10 and TGF-beta1 in episodic TTH, and MCP-1 with IL-10 in migraine with aura. Cytokine increases were modest compared with those often accompanying serious neurological conditions, and may represent a mild response to pain. We believe this to be the first comparative study of CSF cytokine levels in connection with headache.


Assuntos
Citocinas/líquido cefalorraquidiano , Transtornos de Enxaqueca/líquido cefalorraquidiano , Cefaleia Pós-Traumática/líquido cefalorraquidiano , Cefaleia do Tipo Tensional/líquido cefalorraquidiano , Adolescente , Adulto , Idoso , Quimiocina CCL2/líquido cefalorraquidiano , Feminino , Humanos , Interleucina-10/líquido cefalorraquidiano , Masculino , Pessoa de Meia-Idade , Receptores de Interleucina-1/análise , Fator de Crescimento Transformador beta1/líquido cefalorraquidiano
2.
Eur J Med Res ; 12(6): 249-54, 2007 Jun 27.
Artigo em Inglês | MEDLINE | ID: mdl-17666314

RESUMO

BACKGROUND: Chronic headache after whiplash injury is common, but the underlying mechanisms have not yet been elucidated. On the basis of human neuroanatomy, we hypothesize that rear-end collision can cause leakage of the cerebrospinal fluid (CSF) into the epidural space most frequently at the lumbosacral level, inducing chronic headache. METHODS: We considered that the following phenomena would be evident in patients with chronic headache after rear-end collision: (1) orthostatic headache with early onset and long duration, (2) low intracranial pressure (ICP =or< 60 mm H2O), (3) CSF leakage mainly in the lumbosacral region on radioisotope-myelocisternography, and (4) diffuse pachymeningeal enhancement (DPE) on gadolinium enhanced magnetic resonant image (Gd-MRI). The clinical signs and symptoms, ICP and neuroimaging findings were analyzed retrospectively in 20 patients who complained of chronic headache after rear-end collisions. RESULTS: Headaches were orthostatic and started on the day of the accident in 14 patients. The headaches lasted more than 3 months in all patients. Mean ICP was 120 +/- 30 cm H2O. Only one patient showed low ICP. RI-myelocisternography revealed signs of CSF leakage at the lumbosacral level in 10 patients. Gd-MRI showed no abnormalities known to be characteristic of spontaneous intracranial hypotension (SIH). Chronic headache disappeared or was diminished in all patients by epidural blood patching in the lumbosacral region. CONCLUSION: This clinical study partly supports the validity of our verifiable hypothetical mechanism. The ICP is not low and DPE is not observed on Gd-MRI. Therefore, CSF leakage into the epidural space may not occur, but spinal CSF absorption may be over-activated. This condition may represent a new clinical entity.


Assuntos
Cefaleia Pós-Traumática/patologia , Cefaleia Pós-Traumática/fisiopatologia , Adulto , Doença Crônica , Cisterna Magna/patologia , Feminino , Humanos , Pressão Intracraniana , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Cefaleia Pós-Traumática/líquido cefalorraquidiano , Espaço Subaracnóideo/patologia
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