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Related Concept Videos

Cerebral Edema ll: Pathophysiology01:22

Cerebral Edema ll: Pathophysiology

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Vasogenic edema is a major form of cerebral edema characterized by abnormal accumulation of fluid in the brain’s extracellular space due to disruption of the blood–brain barrier (BBB). The BBB is a specialized structure composed of endothelial cells connected by tight junctions, supported by astrocytic endfeet and a basement membrane. Under normal conditions, it tightly regulates the movement of ions, proteins, and solutes between the bloodstream and brain parenchyma. When this...
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Related Experiment Video

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3D-Neuronavigation In Vivo Through a Patient's Brain During a Spontaneous Migraine Headache
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Endothelial function in migraine with aura - a systematic review.

Jawad H Butt1, Ulriche Franzmann, Christina Kruuse

  • 1Department of Neurology, Neurovascular Research Unit, Copenhagen University Hospital Herlev, Herlev, Denmark.

Headache
|December 30, 2014
PubMed
Summary

Endothelial dysfunction may not be a primary factor in migraine with aura (MA) patients, despite some studies showing increased endothelial activation markers. Further research is needed to clarify the role of endothelial changes in stroke risk for MA patients.

Keywords:
endothelial functionendothelial progenitor cellflow-mediated dilationischemic strokemigraine with auraperipheral arterial tonometry

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Area of Science:

  • Neurology
  • Cardiovascular Science
  • Vascular Biology

Background:

  • Young individuals with migraine with aura (MA) have a higher risk of ischemic stroke.
  • Endothelial dysfunction is a potential contributing factor to this increased stroke risk.
  • This review examines current evidence on endothelial function in MA patients.

Purpose of the Study:

  • To evaluate the existing evidence regarding endothelial function in patients with migraine with aura (MA).
  • To determine if endothelial dysfunction plays a role in the elevated ischemic stroke risk observed in young MA patients.

Main Methods:

  • Systematic literature search of Medline, Embase, and Cochrane library databases.
  • Inclusion of studies assessing endothelial function using various methods like flow-mediated dilation, peripheral arterial tonometry, and venous occlusion plethysmography.
  • Analysis of studies investigating arterial function, endothelial progenitor cells, endothelial markers (inflammation, oxidative stress, coagulation), and cerebral endothelial function.

Main Results:

  • Conflicting results were observed for flow-mediated dilation, with some studies showing no difference and others reporting increases or decreases in migraineurs.
  • Arterial function studies indicated increased augmentation index and decreased arterial distensibility in migraineurs, but pulse wave velocity findings were inconsistent.
  • Elevated endothelial activation markers related to inflammation, oxidative stress, and coagulation were found in MA patients, alongside reduced endothelial progenitor cells in some studies.

Conclusions:

  • Current evidence suggests endothelial dysfunction may not be significantly important in MA patients, though studies are limited.
  • Increased endothelial biomarkers indicate potential subtle endothelial changes in MA patients.
  • Further large-scale studies combining endothelial dysfunction testing and biomarker analysis are necessary to elucidate the role of endothelial changes in stroke risk for young MA patients.