Timing and topography of cerebral blood flow, aura, and headache during migraine attacks
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Timing and topography of cerebral blood flow, aura, and headache during migraine attacks. / Olesen, J; Friberg, L; Olsen, T S; Iversen, Helle Klingenberg; Lassen, N A; Andersen, A R; Karle, A.
In: Annals of Neurology, Vol. 28, No. 6, 12.1990, p. 791-8.Research output: Contribution to journal › Journal article › Research › peer-review
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T1 - Timing and topography of cerebral blood flow, aura, and headache during migraine attacks
AU - Olesen, J
AU - Friberg, L
AU - Olsen, T S
AU - Iversen, Helle Klingenberg
AU - Lassen, N A
AU - Andersen, A R
AU - Karle, A
PY - 1990/12
Y1 - 1990/12
N2 - Ten years of study has resulted in considerable but fragmented knowledge about regional cerebral blood flow in migraine with aura (classic migraine). In the present study, the number of repeatedly studied patients (n = 63) was large enough to determine statistically significant sequences of events and statistically significant spatial relations. The first observable event was a decrease of regional cerebral blood flow posteriorly in one cerebral hemisphere. Further development of this pathological process was accompanied by the aura symptoms. Thereafter headache occurred while regional cerebral blood flow remained decreased. During the headache phase, regional cerebral blood flow gradually changed from abnormally low to abnormally high without apparent change in headache. In some patients headache disappeared while regional cerebral blood flow remained increased. Although regional cerebral blood flow reduction and aura symptoms in the great majority of patients were unilateral, one-third had bilateral headache. Unilateral headache usually localized to the side on which regional cerebral blood flow was reduced and from which the aura symptoms originated (i.e., aura symptoms were perceived to occur contralaterally but presumably originated in the hypoperfused hemisphere). Our results suggest a simple model for migraine attacks: A pathological disturbance in one cerebral hemisphere causes the aura symptoms and after a time delay, it also causes the headache by stimulating local vascular nociceptors. Bilateral headache caused by a unilateral cerebral disturbance may be explained by recent neuroanatomical and neurophysiological findings.
AB - Ten years of study has resulted in considerable but fragmented knowledge about regional cerebral blood flow in migraine with aura (classic migraine). In the present study, the number of repeatedly studied patients (n = 63) was large enough to determine statistically significant sequences of events and statistically significant spatial relations. The first observable event was a decrease of regional cerebral blood flow posteriorly in one cerebral hemisphere. Further development of this pathological process was accompanied by the aura symptoms. Thereafter headache occurred while regional cerebral blood flow remained decreased. During the headache phase, regional cerebral blood flow gradually changed from abnormally low to abnormally high without apparent change in headache. In some patients headache disappeared while regional cerebral blood flow remained increased. Although regional cerebral blood flow reduction and aura symptoms in the great majority of patients were unilateral, one-third had bilateral headache. Unilateral headache usually localized to the side on which regional cerebral blood flow was reduced and from which the aura symptoms originated (i.e., aura symptoms were perceived to occur contralaterally but presumably originated in the hypoperfused hemisphere). Our results suggest a simple model for migraine attacks: A pathological disturbance in one cerebral hemisphere causes the aura symptoms and after a time delay, it also causes the headache by stimulating local vascular nociceptors. Bilateral headache caused by a unilateral cerebral disturbance may be explained by recent neuroanatomical and neurophysiological findings.
KW - Adolescent
KW - Adult
KW - Aged
KW - Brain Mapping
KW - Cerebral Angiography
KW - Cerebral Cortex
KW - Cerebrovascular Circulation
KW - Female
KW - Functional Laterality
KW - Humans
KW - Male
KW - Middle Aged
KW - Migraine Disorders
KW - Time Factors
KW - Tomography, Emission-Computed, Single-Photon
U2 - 10.1002/ana.410280610
DO - 10.1002/ana.410280610
M3 - Journal article
C2 - 2285266
VL - 28
SP - 791
EP - 798
JO - Annals of Neurology
JF - Annals of Neurology
SN - 0364-5134
IS - 6
ER -
ID: 128984708