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Fig. 2 | The Journal of Headache and Pain

Fig. 2

From: Mechanisms of migraine as a chronic evolutive condition

Fig. 2

Migraine pathophysiology involves activation of the hypothalamic region during the early premonitory phase, and activation of the trigeminal system during the headache phase. Cortical spreading depression (CSD) is thought to be the biological process of the migraine aura. How activation of the hypothalamus may lead to the development of CSD and activation of the trigeminal system remains unknown. Potentially the hypothalamus may activate direct or indirect pathways involving other brain areas, such us the brainstem, or the parasympathetic system, leading to the development of migraine aura and activation of the ascending trigeminothalamic pathway

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