Delayed hyperemia following hypoperfusion in classic migraine. Single photon emission computed tomographic demonstration

A. R. Andersen, L. Friberg, T. S. Olsen and J. Olesen
Department of Neurology, Rigshospitalet, Copenhagen, Denmark.

Regional cerebral blood flow (rCBF) was measured in seven patients during classic migraine attacks. Single photon emission computed tomography was performed soon after hospital admission, and three to eight hours, 20 to 24 hours, and one week later after the onset of symptoms. Initially reduced rCBF persisting up to three hours was observed in the hemisphere appropriate to the focal neurologic deficit; hyperperfusion was noted later in the same region in these patients. At 24 hours rCBF was normal in four patients, hyperemia persisted in two patients, and one patient was not restudied. The area of interest demonstrated a mean decrease of 19% +/- 7% in side-to-side asymmetry when compared with the contralateral region. In three to eight hours this reversed to a mean increase of 19% +/- 4% (delayed hyperemia). No asymmetries were observed after one week. The late hyperemic asymmetry often persisted beyond the duration of the clinical headache. It is postulated that this tardive regional hyperperfusion is a consequence of previous focal arteriolar vasoconstriction. This vascular sequence of events further delineates the diagnostic merit of studying rCBF by noninvasive single photon emission computed tomography in migraine.

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Migraine as an inflammatory disorder
Waeber and Moskowitz
Neurology 2005;64:S9-S15.
FULL TEXT  

Migraine and other headaches: Associations with Rose angina and coronary heart disease
Rose et al.
Neurology 2004;63:2233-2239.
ABSTRACT | FULL TEXT  

A Case of Hemiplegic Migraine in Childhood: Transient Unilateral Hyperperfusion Revealed by Perfusion MR Imaging and MR Angiography
Masuzaki et al.
Am. J. Neuroradiol. 2001;22:1795-1797.
ABSTRACT | FULL TEXT  

Metabolic Characterization of Spinocerebellar Ataxia Type 6
Soong et al.
Arch Neurol 2001;58:300-304.
ABSTRACT | FULL TEXT  

Treatment of a prolonged migrainous aura with intravenous furosemide
Rozen
Neurology 2000;55:732-733.
FULL TEXT  

Hemiplegic Migraine Induced by Exertion
Razavi et al.
Arch Neurol 2000;57:1363-1365.
ABSTRACT | FULL TEXT  

Migraine: still a vascular illness?
Olsen
Vasc Med 1991;2:147-159.
 

Mechanisms of migraine aura revealed by functional MRI in human visual cortex
Hadjikhani et al.
Proc. Natl. Acad. Sci. USA 2001;98:4687-4692.
ABSTRACT | FULL TEXT