Nerves and Vessels in the Pterygopalatine Fossa and Symptoms of Cluster Headache

SYNOPSIS The study evaluates the contribution of activated parasympathetic and sensory nerve fibres in the sphenopalatine ganglion area, and of vasodilation in surrounding vessels in this narrow region (pterygopalatine fossa), to the pain and signs of autonomic dysfunction seen during attacks of cluster headache. Agents with anesthetic and vasoconstrictor effects were applied nasally to reach this area. It was found that the anesthetic effect is the most important, both regarding pain and autonomic symptoms. The effectiveness was also evaluated: this treatment is useful to stop attacks of cluster headache, but the beneficial effect is less than that reported in previous studies.