HEADACHES AND THE HYPOTHALMUS [ back to What's New ]
Neurologists have believed for years that severe headaches such as migraines were a vascular phenomenon, in which transient release of chemical substances caused transient, reversible expansion of blood vessels surrounding the brain, which could be relieved each time the headache occurred by administration of drugs which constrict the swollen blood vessels. Peter Goadsby of the National Hospital for Neurology and Neurosurgery in London, published a paper in Nature on July 1, 1999, which for the first time establishes the existence of permanent anatomic changes in the brain tissue associated with one type of severe headache, known as cluster headache. A cluster headache attacks one small area on one side of the head (such as the temple near the left eye) and causes excruciating pain in that spot for weeks or months, sometimes driving the victim to thoughts of suicide. Using PET scans Dr. Goadsby found abnormal metabolism going on in the hypothalamus on the same side of the  brain as the headaches. Then, applying  a new technique called voxel-based morphometry to brain MRIs of cluster headache patients, he found tiny anatomic changes in the same area of the hypothalamus consisting of unusually dense concentrations of gray matter neurons, i.e. far more than the expected number of brain cells in that one spot. This could lead one day to better treatments for cluster headache, and to greater understanding of migraine headache as well.