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Spreading Cerebral Oligemia in Classical‐ and Normal Cerebral Blood Flow in Common Migraine

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SYNOPSIS Regional cerebral blood flow was studied with intra‐arterial 133Xenon technique in 254 areas of a hemisphere during the development of classical migraine attacks in seven patients. We describe a gradual spread of reduced cerebral blood flow starting at the posterior pole of the hemisphere and advancing in a mode quite similar to the spreading depression phenomenon of Leao. In three patients the oligemia was preceeded by focal or perifocal hyperemia. Functional activation by speech etc. was usually impaired or abolished during prodromes or accompaniments. Headache was found concommitantly with cerebral blood flow reduction and cannot be caused by reactive hyperemia in these patients. Similar findings were made in two patients studied with tomographic 133Xenon technique. During induced common migraine attacks repeated cerebral blood flow studies with stationary detectors (N =3) and with tomographic technique (N =4) revealed no alterations of global or cerebral blood flow. Also tomographic determination of spontaneous common migraine attacks in four patients was normal. It is concluded that the two forms of migraine are different with respect to cerebral blood flow abnormalities and that they should be studied separately in the future. Greater interest should be directed towards the phenomenon of spreading depression as a possible model of the classical migraine attack.

OriginalsprogEngelsk
TidsskriftHeadache: The Journal of Head and Face Pain
Vol/bind22
Udgave nummer6
Sider (fra-til)242-248
Antal sider7
ISSN0017-8748
DOI
StatusUdgivet - 1 jan. 1982

ID: 201460043