Abstract
Tension-type headache is the most frequent type of headache. The paper deals with the till now accepted mechanisms, which can be involved in pathophysiology of this type of headache.
The examination of myofascial tenderness and pain thresholds gives evidence for the participation of peripheral mechanisms in infrequent episodic form, in frequent episodic and chronic form besides peripheral and also central mechanisms are involved. The basis of peripheral mechanisms can be the dysfunction of neuromuscular junction in myofascial trigger pionts with lack of adenosin priphosphate.
Local ischemia then releases the substances, which are involved in pain and inflammation. The basis of central mechanism can be the central senzitization at the level of the posterior horn of the upper cervical spinal cord and trigeminal nucleus, alternatively in higher centers of the pain pathway. the role of stress and nitric oxide in the pathopsysiology of chronic form is mentioned.
In the second part the treatment of acute attacks and prophylactic treatment in frequent episodic and chronic form are described.