My consideration will deal with pain associated primarily with extracranial vasomotor reactions, usually subsumed under the heading of migraine. In a strict sense all headache has a vascular component. Practically all of the larger vascular channels in the head are pain-sensitive. Distention of them, or inflammation and irritation about them, or direct pressure or traction on them may result in pain in the head. Such a relatively uncomplicated mechanism as steady contraction of muscles of the head and neck which of itself results in pain (termed tension headache) will eventually reduce the caliber of the vessels to muscle by reason of their compression, stimulating further muscle reaction and pain. Disorders of the eyes, ears, nose, sinuses, teeth, and the cervical vertebrae, which may be associated with local pain, also may result in pain at a distance associated with prolonged muscle contraction and vasomotor reaction.
According to the way I view
ARING CD. Vascular Headache. Arch Intern Med. 1962;109(1):18–25. doi:10.1001/archinte.1962.03620130020003
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