Cerebral Circulatory Changes During Migraine Headache With Aura

Abstract

Many authors report alterations of cephalic (both intracranial and extracranial) blood flow and vascular responsiveness in patients with migraine. In the majority of reports, rCBF has been decreased during the prodromal phase and increased during and immediately after the headache phase of migraine attacks. Abnormal vascular responsiveness has been demonstrated, not only during each attack, but also between attacks. Pharmacological and therapeutic evidence that many vasoactive agents induce, prevent or abolish attacks of migraine headache are consonant with the close relationships that exist between vascular abnormalities and the pathogenesis of migraine with aura. This is particularly true of the marked therapeutic effectiveness of calcium entry blockers, which are effective in the prophylaxis of migraine, and sumatriptan, which has direct vasoconstrictive effects, with relief of the headache, which lends strong support to a vascular hypothesis.