Focal vascular headaches with focal arterial disease. An ultrasonographic analysis

The relationship between migraine and premature stroke and heart disease has been firmly established in the literature. The probable mechanism relates to release of vasoactive agents locally that produce intimal changes and if chronic may lead to permanent changes to the artery. We have attempted to identify individuals at risk for premature stroke utilizing the highly accurate B-mode real time carotid ultrasonogram. Sixteen patients demonstrated varying degrees of focal dilatation or plaque disease and 44% had abnormal Doppler flow studies. Since many of these patients were asymptomatic during the examination it is suggested that vascular changes may be more persistent than were previously suspected. These plaques, in the setting of increased platelet aggregability may be responsible for the augmented risk of stroke. Precise identification of these individuals can be easily accomplished with B-mode real time scanning (High resolution), and will allow for safe followup if specific dietary or drug interventions are contemplated.