Mapping the Brain in Primary Headache Disorders

Primary headache disorders, including migraine and the trigeminal autonomic cephalalgias, are characterized by normal clinical examination and structural brain imaging. While a central nervous system origin for these disorders has been postulated since the nineteenth century, only recently with the development of functional brain imaging has this been directly studied. Brain imaging methods have enabled the identification of structures underlying headache and hallmark symptoms, such as photophobia, premonitory symptoms, and typical migraine aura. This article gives an integrated view of the clinical presentation and associated functional changes in the brains of patients with primary headache disorders.