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Neurological Sciences
Published in: Neurological Sciences 2/2020

01-12-2020 | Migraine | HEADACHES IN CSF DYNAMICS DISORDERS

Headache in idiopathic intracranial hypertension. A CGRP-dependent head pain?

Authors: Roberto De Simone, Mattia Sansone, Vincenzo Bonavita

Published in: Neurological Sciences | Special Issue 2/2020

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Abstract

Headache is the most frequent and often the most severe symptom of idiopathic intracranial hypertension (IIH) clinical presentation, although pain characteristics are very variable among sufferers and the pain may even lack in some cases. Whatever the headache features, refractoriness to treatments, pain worsening in the recumbent position, and frequent awakenings with severe headache late in the night are the specific complains of such patients. However, a migraine or probable migraine headache, mostly with a chronic headache pattern, can be diagnosed in about 2/3 of the cases. In IIH cases without papilledema (IIHWOP), this leads to a high rate of misdiagnosis with primary chronic migraine (CM). Mechanisms responsible for the shared migrainous presentation of CM and IIH/IIHWOP may rely on a pathologic CGRP release from the rich trigemino-vascular innervated dural sinuses, congested in the course of raised intracranial pressure. The possible role of IIHWOP as a powerful and modifiable risk factor for migraine progression is discussed. Further studies investigating the possible efficacy of anti CGRP/receptor antibodies in IIH/IIHWOP headache treatment are needed.
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Metadata
Title
Headache in idiopathic intracranial hypertension. A CGRP-dependent head pain?
Authors
Roberto De Simone
Mattia Sansone
Vincenzo Bonavita
Publication date
01-12-2020
Publisher
Springer International Publishing
Published in
Neurological Sciences / Issue Special Issue 2/2020
Print ISSN: 1590-1874
Electronic ISSN: 1590-3478
DOI
https://doi.org/10.1007/s10072-020-04641-w

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