By
Giuseppi Nappi, IRCSS Mondino, Pavia and Rome, Italy
Michael Moskowitz, MD, Professor of Neurology, Harvard Medical School,
Neurosurgery and Neurology, Massachusetts General Hospital, Boston, MA

Migraine and other headaches are among the most frequent symptoms encountered
in medicine. It has been estimated that at least 40% of neurological consultations
are triggered by headache-related problems. The very high frequency of headache has
made some physicians wonder whether one should call a condition that affects so many
people a .disease.. Headache sufferers, however, know better and have been relying
for centuries on the knowledge of physicians to alleviate their symptoms. The editors
of the previous series of the Handbook of Clinical Neurology certainly recognized the
importance of the problem and, following four volumes dealing with neurological
functions and their disturbances, they dedicated the first nosological volume (volume 5
of the first series) to headaches. They commented that the volume reflected the extent
of our knowledge and ignorance about headache at that time (1968). As the reader will
see, we have come a long way since then. In the second series, a volume on headaches was
published in 1985, and the preface to that volume stated that this Cinderella of academic
neurology had been transformed into an attractive princess courted by a growing circle of
admirers. This is even truer today. The present volume is part of the third series of the
Handbook, for which we have editorial responsibility. In order to provide insight into
physiological and pathogenetic mechanisms, and a basis for new therapeutic strategies for
neurological disorders, we have specifically ensured that the neurobiological aspects of
the nervous system in health and disease are covered, as well as more clinical aspects of
neurological disease. During the last half-century, dramatic advances in the clinical and
basic neurosciences have occurred, and these are emphasized in each volume of the Handbook.
The present volume deals with various aspects of headaches. Until a few years ago,
relatively little could be done in terms of therapeutic intervention and prevention of
headaches, and in the headache volumes in the earlier series only few chapters dealt with
therapy. Advances in our understanding of the biochemical background of headaches coupled
with advances in fields as diverse as pharmacology, epidemiology, genetics, neuroimaging,
interventional radiology, surgery, and even clinical psychology have profoundly altered our
approach to headache. In the present volume, for example, no less than 15 chapters cover
therapy, including prevention and management. Our goal is to provide basic researchers with
the foundations for new investigative studies. We also intend to give clinicians a source
reference to enable them to gain a thorough knowledge and understanding of the clinical
features and management of the many manifestations of headaches.

Download File Size:14.53 MB

---