Regional cerebral blood flow in the different clinical types of migraine.

Abstract

SYNOPSISModifications of regional cerebral blood flow (rCBF) were measured during different phases of different types of migrainous headache in a population of 180 migraineurs, using the 133Xenon inhalation technique. Mean hemispheric and regional distribution of flow were compared to normal values obtained in age‐matched normal controls. Generalized, and particularly fronto‐temporal, increase of the fast flow (F1) component was found during the acute phase of common migraine ( + 37%) with a progressive decrease during the days following. Comparable changes were observed for the slow component of blood flow (F2). During the interictal period, the only difference between normals and migraineurs was an enhanced fronto‐temporal predominance of the fast flow values (F1). In the accompanied forms of migraine, the major finding was the presence of two subgroups of patients: in the first group, reduced flow was correlated with the neurological deficit, while in the second, high flows were measured in the presence of neurological deficits. A review of the personal history of each patient revealed that the two subgroups differed in age, sex, time course of the headache and past history of migraine. The high flow group was more characteristic of migraine while the oligemic group raised the questions of either another pathophysiological mechanism {vasospasm) or of another degree of severity of the same disease. The two hypotheses are discussed in the light of review of the literature.