Migraine headache

Migrenska glavobolja je primarna glavobolja koja se smatra trećim najčešćim poremećajem, te sedmim najčešćim specifičnim uzrokom onesposobljenja u svijetu. Karakterizirana je unilateralnom, a katkad i bilateralnom boli u području čela, oka i sljepoočnice. Bol je pulsirajućeg karaktera, često počinje u zatiljku te se širi prema čelu. Popraćena je mučninom, povraćanjem, fotofobijom i fonofobijom. U nekim slučajevima je popraćena premonitornim razdobljem, aurom, zatim i popratnim razdobljem rezolucije glavobolje. Simptomi premonitornog i rezolucijskog razdoblja uključuju hiperaktivnost, hipoaktivnost, depresiju, povećanu potrebu za određenom vrstom hrane, učestalo zijevanje, umor, te ukočenost i/ili bolnost vrata. Aura je karakterizirana prolaznim neurološkim ispadima. Patohistološki mehanizam nastanka migrenske glavobolje još uvijek nije potpuno poznat, no smatra se da u mehanizmu nastanka utječu neurovaskularni mehanizmi u kojima trigeminalni živac i 5-hidroksitriptamin imaju glavnu ulogu. Liječenje migrenskih glavobolja je usmjereno na prekidanje ili prevenciju akutnog napadaja. Prema trećem izdanju Internacionalne klasifikacije poremećaja glavobolje iz 2013. godine migrenske glavobolje su podijeljene u 6 entiteta: migrenu bez aure, migrenu s aurom, kroničnu migrenu, komplikacije migrene, vjerojatnu migrenu i epizodične sindrome koji mogu biti povezani s migrenom Cilj ovoga preglednog rada je dati pregled migrenskih glavobolja, naglasiti njihove kliničke manifestacije i posebnosti, te predstaviti nove diferencijalno-dijagnostičke kriterije (ICHD-3 2013).Migraine headache is a common debilitating primary headache. It is ranked as the third most prevalent disorder and seventh-highest specific cause of disability worldwide. It is characterized by unilateral, sometimes bilateral headaches in the area of the forehead, eye and the temporal. The pain has a pulsating quialty, often beginning in the occiput then spreading thowards the forehead where it reaches its maximum. The pain is accompanied by nausea, vomiting, photofobia and phonofobia. In some cases the headache is preeceded by a premonitory phase, then by an aura and afterwards followed by a headache resolution phase. Premonitory and resolution symptoms include hyperactivity, hypoactivity, depression, cravings for particular foods, repetitive yawning, fatigue and neck stiffness and/or pain. Aura is characterized by fully reversible neurological symptoms. The pathology of the migraine has not yet been fully understood. However, it is considered that neurovascular mechanisams, the trigeminal nerve and 5-hydroxytriptamine have a leading role in the mechanisam of the migraine headache. The treatment of these headaches is aimed thowrads either stopping or preventing acute attacks. According to the third edition ih the International Classification of Headache Disorders from 2013, migraine headache is classified into 6 entities: migraine without aura, migraine with aura, chronic migraine, complications of migraine, probable migraine and episodic syndromes that may be associated with migraine. The aim of this review is to provide an overview of migraine headaches, outline their clinical manifestations and introduce new differential diagnostic criteria (ICHD-3 2013)