HYPERPERFUSION OF CEREBRAL-CORTEX, THALAMUS AND BASAL GANGLIA DURING SPONTANEOUSLY OCCURRING MIGRAINE HEADACHES
HYPERPERFUSION OF CEREBRAL-CORTEX, THALAMUS AND BASAL GANGLIA DURING SPONTANEOUSLY OCCURRING MIGRAINE HEADACHES
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DOI：
10.1111/j.1526-4610.1989.hed2905282.x
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发表时间：
1989-05-01
期刊：
影响因子：
5
通讯作者：
ORAVEZ, WT
中科院分区：
文献类型：
--
作者：
KOBARI, M;MEYER, JS;ORAVEZ, WT
采用稳定的氙增强计算机断层扫描（SPECT-CBF）方法，以前瞻性方式对22例确诊为常见或典型偏头痛的患者进行局部脑血流（LCBF）的彩色编码横断面成像。自发性头痛患者（N = 12）的LCBF显著高于无头痛患者（N = 10）25- 35%。高灌注不仅累及大脑皮质，还累及皮质下结构，包括丘脑、基底节和皮质下白色物质。LCBF的增加是双侧的，有时是不对称的，但LCBF的增加并不总是与头痛的优势侧相关。在普通型（N = 6）和经典型（N = 6）偏头痛患者中，头痛期间脑灌注过度的程度或模式无显著差异。结果表明，一个共同的病因为普通和经典偏头痛。结果与偏头痛的原因是扩散性少血症或扩散性皮质抑制不一致。脑灌注过多似乎是由伴随偏头痛的各种神经原性和化学变化介导的。偏头痛的单侧性质更可能是由于颅外血管扩张。
Color-coded, cross-sectional imaging of local cerebral blood flow (LCBF) was made in a prospective manner among 22 patients with well-established common or classic migraine utilizing the stable xenon-enhanced computed tomographic (Xe CT-CBF) method. LCBF in patients during spontaneously occurring headaches (N = 12) were significantly higher compared to patients without headache (N = 10) by 25-35%. The hyperperfusion involved not only cerebral cortex but also subcortical structures including thalamus, basal ganglia, and subcortical white matter. LCBF increases were bilateral and sometimes asymmetrical, but LCBF increases were not consistently related to the preponderant side of headache. No significant differences were observed in the degree or pattern of cerebral hyperperfusion during headaches compared among common (N = 6) and classic (N = 6) migraineurs. Results suggest a common etiology for both common and classic migraine. Results are not consistent with spreading oligemia or spreading cortical depression as a cause of migraine. The cerebral hyperperfusion appears to be mediated by various neurogenic and chemical changes accompanying migraine. The unilateral nature of migraine head pain is more likely due to dilation of extracranial vessels.