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Related Experiment Videos

Cerebral blood flow in chronic posttraumatic headache

S J Gilkey1, N M Ramadan, T K Aurora

  • 1Department of Neurology, Henry Ford Hospital and Health Sciences Center, Detroit, Mich., USA.

Headache
|December 31, 1997
PubMed
Summary

Patients with posttraumatic headache (PTH) exhibit reduced cerebral blood flow and asymmetries, suggesting an organic basis for this condition. These findings highlight potential biomarkers for diagnosing PTH after head injury.

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Area of Science:

  • Neurology
  • Radiology
  • Medical Imaging

Background:

  • Headache is a common sequela of minor closed head injury.
  • Objective evidence for cerebral pathology in posttraumatic headache (PTH) is often lacking.
  • This study investigates cerebral blood flow alterations in PTH.

Purpose of the Study:

  • To determine if patients with chronic posttraumatic headache exhibit altered regional cerebral blood flow (rCBF).
  • To compare rCBF in PTH patients with nonheadache controls and migraineurs.
  • To identify potential objective markers for the organic basis of PTH.

Main Methods:

  • Retrospective analysis of regional cerebral blood flow (rCBF) studies using the xenon Xe 133 inhalation technique.
  • Compared 35 patients with chronic PTH to 49 nonheadache controls and 92 migraineurs.

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  • Adjusted for baseline variables (blood pressure, hematocrit, PCO2) using analysis of covariance.

    • Main Results:

    • PTH patients showed significantly lower mean initial slope indices (a measure of rCBF) compared to controls and migraineurs.
    • PTH patients exhibited increased regional interhemispheric flow differences (rIFD) and hemispheric asymmetries.
    • Lower mean initial slope indices and hemispheric asymmetry independently predicted PTH compared to controls and migraineurs.

    Conclusions:

    • Patients with chronic posttraumatic headache demonstrate reduced regional cerebral blood flow.
    • Significant regional and hemispheric blood flow asymmetries are present in PTH patients.
    • These cerebral hemodynamic alterations provide evidence for an organic basis of chronic posttraumatic headache.