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Cluster headache is characterized by severe, unilateral headache attacks of orbital, supraorbital or temporal pain lasting 15-180 min accompanied by ipsilateral lacrimation, rhinorrhea and other cranial autonomic manifestations. Cluster headache attacks need fast-acting abortive agents because the pain peaks very quickly; sumatriptan injection is the gold standard acute treatment. First-line preventative drugs include verapamil and carbolithium. Other drugs demonstrated effective in open trials include topiramate, valproic acid, gabapentin and others. Steroids are very effective; local injection in the occipital area is also effective but its prolonged use needs caution. Monoclonal antibodies against calcitonin gene-related peptide are under investigation as prophylactic agents in both episodic and chronic cluster headache. A number of neurostimulation procedures including occipital nerve stimulation, vagus nerve stimulation, sphenopalatine ganglion stimulation and the more invasive hypothalamic stimulation are employed in chronic intractable cluster headache.

Societies should be analyzed not only from the point of view of what they talk about but also from the point of view of what they are quiet about. Areas of silence in the semiosphere vary across cultures and history and stem from a complex interaction of historical circumstances and social agencies. Implicit norms of taciturnity are often codified into explicit legal frameworks, whose enforcement, though, substantially relies on state and government propaganda. Citizens must interiorize as a second nature the ideology of taciturnity that leads them not to share any content about certain topics. This mechanism of hegemonic silencing is macroscopically visible in times of war, when national interests solidify into specific rhetorics of taciturnity. This article is a comparative analysis of World War II silence propaganda. However, in times of relative peace both autocratic regimes and democratic states also need areas of silence and secrecy to pattern public discourse. Understanding how the creation...

Cluster headache is an excruciating pain syndrome characterized by unilateral head pain attacks, lasting between 15 and 180 min, accompanied by marked ipsilateral cranial autonomic symptoms, such as lacrimation and conjunctival injection. Despite important insights provided by neuroimaging studies and deep brain stimulation findings, the pathophysiology of cluster headache and its pathways of chronicization are still elusive. In this mini-review, we will provide an overview of the functional and structural neuroimaging studies in episodic and chronic cluster headache conditions conducted to clarify the underlying pathophysiology.

Cluster headache (CH) is a trigeminal autonomic cephalalgias (TAC) characterized by strictly unilateral, excruciating painful headaches that occur in association with ipsilateral cranial autonomic features. Neuromodulation for the treatment of CH can involve both peripheral and central targets. Peripheral targets include stimulation of the sphenopalatine ganglion, vagus nerve and the greater occipital nerve. Central targeting includes deep brain stimulation of the posterior hypothalamus/ventral tegmental area as well as high cervical spinal cord stimulation. This chapter explores the mechanisms, operative techniques and clinical evidence supporting each method.

In this afterword, three leading scholars, whose work explores the intersections of media, communication, and religion from different viewpoints, enter in dialog on the subject. Carole Cusack is a historian of religion and the author of groundbreaking works about the relationship between religion, imagination, and popular culture. Massimo Leone is a semiologist whose work has stretched the boundaries between the study of religion and the study of signs, both linguistic and nonlinguistic. Jeffrey Sconce is a scholar in film and media studies whose pioneering monograph, Haunted Media (2000), placed the theme of the supernatural at the forefront of studies in media and communication. Their responses provide a map of potential trajectories to further explore the connections between digital media and the supernatural.

When we discuss pathophysiological background regarding cluster headache, scientific progress over the last 20 years has put us in the fortunate situation that we can divide this question into “what drives cluster headache” and “where is the source of the pain.” For decades these (fundamentally different) questions have been mixed as so little was known about the pathophysiology of this dreadful disease. We have learned so much about modulators and generators of cluster headache attacks and—to be frank—know still relatively little of what structure actually generates the nociceptive input. We therefore focus here on central generating factors (the why) and refer to the Chaps. 8 and 9 in this book (the where) [1, 2].

El ensayo se concentra el retrato de José Gervasio de Artigas, un caso de excepcional interés a la vez histórico e semiótico. Como no existe un retrato al natural del héroe nacional que lo represente en su juventud o en su madurez, y como el único retrato existente fue dibujado por Alfred Demersay en Paraguay cuando Artigas ya era muy mayor y en condiciones físicas precarias, la imagen arquetípica de su rostro se debe a una reconstrucción y rejuvenecimiento hecha por Juan Manuel Blanes (1884). El ensayo conduce un análisis de semiótica de la cultura sobre la construcción del rostro heroico y sus versiones populistas. The essay focuses on the Uruguayan case-study — of exceptional historical and semiotic interest — of the portrait of José Gervasio Artigas. As there is no portrait of the Uruguyan national hero that represents him in his youth or in his maturity, and as the only existing portrait was drawn by Alfred Demersay in Paraguay when Artigas was already very old and in precarious physical conditions. The archetypal image of his face is due to a reconstruction (and rejuvenation) by Juan Manuel Blanes (1884). The essays carry on a cultural semiotic analysis on the construction of the heroic face. Fil: Leone, Massimo. Universidades de Turín; Italia.

The semiotics of phenomena like déjà vus and hallucinations constitute a limit-field of a theory of the sign, but one that offers opportunities to question the fundamental principles of the discipline while at the same time offering the opportunity to address their underlying cognitive processes. The article describes the cognitive nature of déjà vus and hallucinations, briefly reviews the literature about them, and reads them as cognitive perturbations in the light of a semiotics of mental simulacra related to perception, apperception, awareness, memory, and imagination. The article then uses such cognitive and semiotic modeling in order to develop a critique of present-day digital culture, in which the uncritical adoption of a mnemonic ideal based on digital memory jeopardizes one of the key features of embodied memory: imperfection and, as a consequence, the possibility to access aesthetic and temporal singularity. A collective memory prone to déjà vus and hallucinations ensues.

The sensorial access to the law that a society grants to its members is underpinned by a logic of exhibition and disclosure that, in turn, results from a more abstract cultural propensity to either...

The article seeks to establish a dialog, from a semiotic point of view, with the grand cartography of methods in literary criticism proposed by Prof. Zhang Jiang in his famous essay “Imposed interpretation.” While acknowledging that Prof. Zhang Jiang identifies the most crucial weak points of the semiotic methodology, the article nevertheless takes these criticisms as occasions to improve the approach of semiotics, as regards especially the following oppositions: diagrammatic over-schematization versus quest for a more judicious application of the method; overenthusiastic adoption of mathematical formulas versus cautious cross-fertilization between humanities and scientific thought; frantic pursuance of theoretical uniformity versus humble acceptance of literary idiosyncrasies; fundamentalist proclamation of the self-reliance of the text versus thoughtful consideration of the evident links between the text and its contexts. This new theoretical approach, wherein traditional semiotics improves itself in dialog with Prof. Zhang Jiang’s criticisms, is exemplified with reference to the concept of interpretive fidelity, which is categorized into different levels and dimensions of adhesion between the textual structure and the discourse of the meta-language interpreting it: hi-fi, low-fi, no-fi, and wi-fi interpretation.

The article investigates the socio-cultural meaning of the face in relation to its natural and biological features, focusing on the particular domain ofmating habits. After surveying the role of the ‘face’ in the sexual behaviors of several non-human animals, and especially of primates, the article ponders on the crucial role that the face plays in the seductive discourse which precedes and accompany mating in all human cultures and also in many primates’ behaviors. It, then, deals with the transformation that these seductive patterns of signification and communication undergo in the passage from face-to-face intercourse to digital dating. Here, the gap between the necessarily realistic representation of one’s bodily face and the idealized version of it allowed by digital picture editing widens, to the point that new epistemic parameters start to circulate throughout the digital semiosphere.

Eighty percent of people with stroke live in low- to middle-income nations, particularly in sub-Saharan Africa (SSA) where stroke has increased by more than 100% in the last decades. More than one-third of all epilepsy−related deaths occur in SSA. HIV infection is a risk factor for neurological disorders, including stroke and epilepsy. The vast majority of the 38 million people living with HIV/AIDS are in SSA, and the burden of neurological disorders in SSA parallels that of HIV/AIDS. Local healthcare systems are weak. Many standalone HIV health centres have become a platform with combined treatment for both HIV and noncommunicable diseases (NCDs), as advised by the United Nations. The COVID-19 pandemic is overwhelming the fragile health systems in SSA, and it is feared it will provoke an upsurge of excess deaths due to the disruption of care for chronic diseases such as HIV, TB, hypertension, diabetes, and cerebrovascular disorders. Disease Relief through Excellent and Advanced Means (DREAM) is a health programme active since 2002 to prevent and treat HIV/AIDS and related disorders in 10 SSA countries. DREAM is scaling up management of NCDs, including neurologic disorders such as stroke and epilepsy. We described challenges and solutions to address disruption and excess deaths from these diseases during the ongoing COVID-19 pandemic.

The neurophysiology of vision and cognition shapes the way in which human beings visually “read” the environment. A biological instinct, probably selected as adaptive through evolution, pushes them to recognize coherent shapes in chaotic visual patterns and to impute the creation of these shapes to an anthropomorphic agency. In the west as in the east, in Italy as in Japan, human beings have identified faces, bodies, and landscapes in the bizarre chromatic, eidetic, and topologic configurations of stones, clouds, and other natural elements, as though invisible painters and sculptors had depicted the former in the latter. However, culture-specific visual ideologies immediately and deeply mold such cross-cultural instinct of pattern recognition and agency attribution. Giants and mythical monsters are seen in clouds in the west as in the east; both the Italian seventeenth-century naturalist and the Japanese seventeenth-century painter identify figures of animals and plants in stones. And yet, the ways in which they articulate the semantics of this visual recognition, identify its icons, determine its agency, and categorize it in relation to an ontological framework diverge profoundly, according to such exquisitely paths of differentiation that only the study of culture, together with that of nature, can account for.

On the one hand, terrorism is the antithesis of communication. It does not aim at transmitting any message to its victims, but at annihilating them. On the other hand, yet, terrorism is extremely powerful communication for those who witness the tragedy, directly or through the media, and are either terrified or fascinated by it.1 Terrorist acts revolutionize the social attitudes of individuals and groups, pushing them to radically change their lifestyles. Those acts instill fear, but can also attract supporters’ admiration. From September 11 on, terrorist jihadist groups have resorted to increasingly sophisticated communication in order to accompany and influence the reception of their violent deeds. Obeying to a global tendency, for jihadists it was not sufficient to perpetrate violence and instigate terror. It was equally fundamental to let the world know that violence had been committed, and what was the appropriate cognitive, emotional, and pragmatic interpretation of it.

Background: Deep brain stimulation of the posterior hypothalamic area was first introduced in 2000 to treat drug-refractory chronic cluster headache (CH). Findings: So far, hypothalamic stimulation has been employed in 79 patients suffering from various forms of intractable short-lasting unilateral headache forms, mainly trigeminal autonomic cephalalgias. The majority were (88.6%) chronic CH, including one patient who suffered from symptomatic chronic CH-like attacks; the remaining were short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT), one had paroxysmal hemicranias and one symptomatic trigeminal neuralgia. Overall, after a mean follow up of 2.2 years, 69.6% (55) hypothalamic-stimulated patients showed a ≥50% improvement. Conclusions: These observations need confirmation in randomised, controlled trials. A key role of the posterior hypothalamic area in the pathophysiology of unilateral short-lasting headaches, possibly by regulating the duration rather than triggering the attacks, can be hypothesised. Because of its invasiveness, hypothalamic stimulation can be proposed only after other, less-invasive, neurostimulation procedures have been tried.

Introduction Chronic cluster headache is rare and some of these patients become drug-resistant. Occipital nerve stimulation has been successfully employed in open studies to treat chronic drug-resistant cluster headache. Data from large group of occipital nerve stimulation-treated chronic cluster headache patients with long duration follow-up are advantageous. Patients and methods Efficacy of occipital nerve stimulation has been evaluated in an experimental monocentric open-label study including 35 chronic drug-resistant cluster headache patients (mean age 42 years; 30 men; mean illness duration: 6.7 years). The primary end-point was a reduction in number of daily attacks. Results After a median follow-up of 6.1 years (range 1.6–10.7), 20 (66.7%) patients were responders (≥50% reduction in headache number per day): 12 (40%) responders showed a stable condition characterized by sporadic attacks, five responders had a 60–80% reduction in headache number per day and in the remaining three responders chronic cluster headache was transformed in episodic cluster headache. Ten (33.3%) patients were non-responders; half of these have been responders for a long period (mean 14.6 months; range 2–48 months). Battery depletion (21 patients 70%) and electrode migration (six patients – 20%) were the most frequent adverse events. Conclusions Occipital nerve stimulation efficacy is confirmed in chronic drug-resistant cluster headaches even after an exceptional long-term follow-up. Tolerance can occur years after improvement.

The evolution of monotheism within a polytheist culture is strictly connected with the institution of the dialectics between “monolatry” and “idolatry.” On the one hand, one divinity among many becomes the center of an increasingly exclusive cult; on the other hand, this exclusivity unfolds in parallel with the stigmatization of any alternative veneration. The establishment of monolatry is substantiated both in sacred texts, which designate the only god, forbid all others, prescribe the legitimate cult, and condemn deviations, and in liturgy that avoids any reference to multiplicity of transcendence. The liturgical work of monolatry, however, is not only positive, since in addition to regulating the material, verbal, and actional signs of the cult, it also entails a destructive tension. Thus, in establishing monolatry, determining formulae for evoking the only transcendence is as essential as destroying any signs that might contaminate it by representing a rival divinity.

This introductory essay deals with the origins of textual agency and inertia. Texts predominantly work as indexes, icons, or symbols, according to Peirce’s typology of signs. These three types usually exert agency to an increasing extent. The essay seeks to determine the origin of this gradient in the dialectics between motivation and arbitrariness. The more a text is received as motivated, the likelier it is that it might exert a strong agency. This hypothesis leads also to an articulation of the rhetorics of motivation or de-motivation through which communities of interpreters can promote or demote the agentive force of a certain text.

What is the difference between interpreting a literary text during a university lecture and interpreting reality outside of the academe? And what is the difference between interpreting in natural sciences and interpreting in the humanities? Despite evident and known divergences, humanities too can rank their interpretations and aspire to guide the interpretations of society. Three alternative methods can be used so as to test interpretive hypotheses, depending on whether the author’s, the reader’s, or the text’s meaningful intentionality is primarily investigated. The third method is superior to the first two since it leads to the creation of a common meta-discursive space for inter-subjective exchange about meaning. Although adopting an appropriate methodology is essential in textual analysis, that which is even more important is supporting the creation of a community of interpreters that, sharing the same method, engage in the constructive comparison and ranking of interpretive moves.

That which is usually called “common sense” is nothing but the complex deposit of implicit cognitive, pragmatic, and emotional rules through which the members of a society interact with each other and, simultaneously, affirm their belonging to the group. This sense is called “common” both because it is current – meaning that it permeates the daily life of the group in all its manifestations – and because it is shared: it is something that belongs to the community as a whole and something through which, at the same time, the members of the community can belong. What is the relation between “sense” and “common sense”? This question is extremely relevant to semiotics, hermeneutics, and the other disciplines and philosophies of interpretation.

Why did semiotics develop as a discipline that concentrates on the concept of sign, and that sees and interprets the world through this concept? Why was the idea of a science that systematically studies signs welcome in a certain epoch of humanity, and why does it seem so abstruse to most nowadays? Should it be given up, like something that belongs to a remote, vanished past? Or is there something, in semiotics, that still offers answers that no other discipline can provide?