This Article  • References  • Full text PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Contact me when this article is cited  Related Content  • Similar articles in this journal

Ultrastructural Aspects and Pathogenetic Mechanisms

Otto Appenzeller, MD, PhD; Werner J. Becker, MD; Anna Ragaz, MD

Arch Neurol. 1981;38(5):302-306.

Abstract
• The skin of both temples was examined ultrastructurally in six patients with cluster headaches and in three controls. An increased number of mast cells were present in the patients irrespective of whether they were in a cluster period or in a quiescent phase. The mast cells were found perivascularly and in the vicinity of cutaneous nerves in the patients, whereas they were predominately found in perivascular areas in controls. Mast cell degranulation was not more prominent on the side of the pain and occasional degranulated mast cells were found in controls. These findings are consistent with the hypothesis that cluster headache is due to an axonal reflex in the trigeminal system, initiated perhaps by latent viral infection or IgE activation of mast cells.

Author Affiliations
From the Department of Neurology, University of New Mexico School of Medicine, Albuquerque (Dr Appenzeller); the Division of Medicine (Neurology), Calgary General Hospital, Calgary, Alberta, Canada (Dr Becker); and the Dermatopathology Section, Skin and Cancer Unit, New York University Medical Center, New York (Dr Ragaz).

Footnotes
Accepted for publication Aug 19, 1980.

Reprint requests to Department of Neurology, University of New Mexico School of Medicine, Albuquerque, New Mexico 87131 (Dr Appenzeller).