Feeling and seeing headaches

The aim is to deepen ourunderstanding of headache by threeapproaches. First, by trying to feelpatients total experience by elicitingtheir symptoms in detail, and fromtheir reactions to these experiences.Second, by trying to remember onesown experience of headache, andobserving a few patients during differentheadache types. Third, byattempting to see the different mechanismsof headaches by their sites oforigin and their pathophysiology.Migraine, tension–type and clusterheadache are the three headachesexamined by these approaches.Migraine seems to arise from disturbancesof the brains cortex followedby meningeal pain – hence isintracranial in origin. Tension–typeheadache seems to arise fromextracranial muscles, although thepain derives from the fascia or tendonsof those muscles; commonsites are the masticatory apparatusand the neck – hence extracranial.Cluster headache remains a mysteryalthough vasodilatation provokes,and vasoconstriction stops, attacks – hence vasomotor control is therapeuticallyvaluable. It is concluded thatwe need more adventurous ideas todeepen our understanding of theseand other headaches.