Document Detail

Blood pool scintigraphy of the skull in relation to head-down tilt provocation in patients with chronic tension-type headache and controls.
MedLine Citation:
PMID:  15012659     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To investigate the mechanisms behind the increase of chronic tension-type headache during head-down tilt. BACKGROUND: The pathophysiology of chronic tension-type headache is unknown. DESIGN AND METHODS: Ten patients suffering from chronic tension-type headache and 10 age- and sex-matched controls were studied with respect to pain intensity and alterations in cranial blood volume using planar scintigraphy and radiolabeled autologous erythrocytes before, during, and after head-down tilt, a procedure known to increase chronic tension-type headache. RESULTS: Four of 8 patients with chronic tension-type headache studied had increased cerebrospinal fluid pressure. During head-down tilt, the pain increased significantly in the group with chronic tension-type headache (P <.001) while the procedure did not cause headache in the controls. Blood volume significantly increased extracranially and decreased intracranially in both groups during head-down tilt. The extracranial nasal blood volume was significantly related to the pain experienced by the patients with chronic tension-type headache before and during head-down tilt. CONCLUSIONS: Although the changes in blood volume and, presumably, the increase of intracranial pressure were similar in the patients with chronic tension-type headache and the controls, only the patients experienced pain and pain increase during head-down tilt. This indicates that the pre-head-down tilt conditions must be different in the 2 groups and should be related to increased cerebrospinal fluid pressure/intracranial venous pressure in patients with chronic tension-type headache compared with controls. A difference in central mechanisms may, however, also be of importance for the difference in headache provocation in the 2 groups during head-down tilt.
Jan Hannerz; P-O Schnell; Stig Larsson; Hans Jacobsson
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Headache     Volume:  44     ISSN:  0017-8748     ISO Abbreviation:  Headache     Publication Date:  2004 Mar 
Date Detail:
Created Date:  2004-03-11     Completed Date:  2004-05-25     Revised Date:  2009-02-02    
Medline Journal Info:
Nlm Unique ID:  2985091R     Medline TA:  Headache     Country:  United States    
Other Details:
Languages:  eng     Pagination:  223-9     Citation Subset:  IM    
Departments of Neurology, Karolinska Hospital, Stockholm, Sweden.
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MeSH Terms
Blood Volume
Chronic Disease
Gated Blood-Pool Imaging
Head / blood supply*
Head-Down Tilt / physiology*
Middle Aged
Tension-Type Headache / physiopathology*,  radionuclide imaging

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