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[Regional cerebral blood flow during migraine]
1Department of Medicine, Kitasato University.
Rinsho Shinkeigaku = Clinical Neurology
|December 1, 1995
Summary
Migraine with aura involves reduced regional cerebral blood flow (rCBF), likely caused by cerebral vasospasm, not neural depression. This blood flow reduction impacts posterior cerebral artery territories.
Area of Science:
- Neurology
- Neuroimaging
- Cerebrovascular Medicine
Background:
- Migraine with aura (MA) is linked to reduced regional cerebral blood flow (rCBF).
- The cause of rCBF reduction during MA—cerebral vasospasm versus neural depression—remains debated.
Observation:
- Regional cerebral blood flow (rCBF) was measured using high-resolution SPECT in 14 patients with MA.
- rCBF was assessed during interictal periods and, in four patients, during aura episodes.
Findings:
- During visual aura, rCBF reduction (31-49%) occurred in occipital, temporal, and thalamic regions, corresponding to the posterior cerebral artery territory.
- Elevated cerebrospinal fluid lactate levels were observed during headache, suggesting ischemia.
Implications:
- Findings suggest cerebral vasospasm causes rCBF reduction during MA, rather than secondary neural depression.
- The occipital association cortex is implicated as the primary site of rCBF reduction in visual aura.