Stephen J. Schueler, M.D.

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Headache Anatomy

To better understand a headache, it helps to understand the anatomy of the head and brain.

The brain is well protected by:

  • The scalp
  • The skull
  • The dura
    • A tough 3-layer sheath that surrounds the brain and spinal cord
    • Layers include the dura mater (strongest layer), arachnoid mater (middle layer), and pia mater (closest to the brain)

The brain is a complicated structure containing many parts. These include:
  • The cerebrum:
    • Made up of two cerebral hemispheres that are connected in the middle
    • It is the largest part of the brain
    • Each area of the cerebrum performs an important function, such as language or movement
    • Higher thought (cognition) comes from the frontal cortex (front portion of the cerebrum)
    • Outside of the cerebrum are blood vessels
    • There are fluid-filled cavities and channels inside the brain
  • The cerebellum:
    • Located in the lower, back part of the skull
    • Controls movement and coordination
  • The brainstem and pituitary gland:
    • Responsible for involuntary functions such as breathing, body temperature, and blood pressure regulation
    • Pituitary gland is the "master gland" that controls other endocrine glands in the body, such as the thyroid and adrenal glands
    • Pineal gland
  • The cranial nerves:
    • Twelve large nerves exit the bottom of the brain to supply function to the senses such as hearing, vision, and taste
  • The cerebral blood vessels:
    • A complicated system that supplies oxygenated blood and nutrients to the brain

The blood supply to the brain is divided into two main parts:
  • Anterior cerebral circulation:
    • The front of the brain is supplied by the paired carotid arteries in the neck.
  • Posterior cerebral circulation:
    • The back portion of the brain is supplied by the paired vertebral arteries in the spine.

Anatomy examples:
  • Carotid artery branches shown on arteriogram
  • Cerebral arteries viewed in cross-section through middle of brain
  • Cerebral arteries viewed from bottom of brain
  • Cerebral arteries on enhanced CT scan
  • Cerebral arteries on arteriogram

Last Updated: Dec 14, 2010 References
Authors: Stephen J. Schueler, MD; John H. Beckett, MD; D. Scott Gettings, MD
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PubMed Headache References
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  2. Bilchik TR. A review of nonvalidated and complementary therapies for cluster headache. Curr Pain Headache Rep. 2004 Apr;8(2):157-61. [14980151]
  3. Colman I, Brown MD, Innes GD, Grafstein E, Roberts TE, Rowe BH. Parenteral dihydroergotamine for acute migraine headache: a systematic review of the literature. Ann Emerg Med. 2005 Apr;45(4):393-401. [15795718]
  4. Jensen R. Pathophysiological mechanisms of tension-type headache: a review of epidemiological and experimental studies. Cephalalgia. 1999 Jul;19(6):602-21. [10448549]
  5. Manias P, Tagaris G, Karageorgiou K. Acupuncture in headache: a critical review. Clin J Pain. 2000 Dec;16(4):334-9. [11153790]
  6. Rains JC, Penzien DB, McCrory DC, Gray RN. Behavioral headache treatment: history, review of the empirical literature, and methodological critique. Headache. 2005 May;45 Suppl 2:S92-109. [15921506]
  7. Rozen TD. Interventional treatment for cluster headache: a review of the options. Curr Pain Headache Rep. 2002 Feb;6(1):57-64. [11749879]
  8. Smetana GW. The diagnostic value of historical features in primary headache syndromes: a comprehensive review. Arch Intern Med. 2000 Oct 9;160(18):2729-37. [11025782]
  9. Walker RA, Wadman MC. Headache in the elderly. Clin Geriatr Med. 2007 May;23(2):291-305, v-vi. [17462518]
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