CEREBRAL OXYGEN EXTRACTION, OXYGEN-CONSUMPTION, AND REGIONAL CEREBRAL BLOOD-FLOW DURING THE AURA PHASE OF MIGRAINE
CEREBRAL OXYGEN EXTRACTION, OXYGEN-CONSUMPTION, AND REGIONAL CEREBRAL BLOOD-FLOW DURING THE AURA PHASE OF MIGRAINE
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DOI：
10.1161/01.str.25.5.974
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发表时间：
1994-05-01
期刊：
影响因子：
8.3
通讯作者：
KARLE, A
中科院分区：
文献类型：
--
作者：
FRIBERG, L;OLESEN, J;KARLE, A
背景与目的偏头痛的先兆期与局灶性血流变化有关，但这些变化是否与脑代谢的变化有关尚不清楚。方法8例患者行颈动脉造影检查，评估短暂性神经系统发作。脑血流（CBF）结果、血管造影和临床观察随后提示诊断：偏头痛伴有先兆和偶尔的先兆发作，但无头痛。在相同的情况下，脑血管造影后使用动脉内注射Xe-133方法重复记录4至6次区域CBF。取颈动脉和颈内静脉血样，测定氧提取率和脑氧代谢率。结果颈动脉局部CBF技术引起先兆症状，4例患者出现典型偏头痛相关后局灶性脑灌流不足，3例患者出现典型单侧头痛。其余4例患者在检查期间无症状或局部CBF改变。在先兆症状期间，四名患者的总氧提取分数显著增加（平均13%），而在无症状组中，氧提取分数没有显著变化。在有症状的组中，整体氧提取分数的增加与半球CBF的下降相一致（平均12%）。脑代谢氧率基本保持不变，Paco也是如此(2)。结论偏头痛-先兆期局灶血流减少不是脑代谢减少的继发现象。然而，小动脉血管收缩可能为偏头痛先兆期间观察到的局部CBF变化提供了可能的解释。
Background and Purpose The aura phase of migraine is associated with focal blood flow changes, but it has been largely unknown whether these changes are correlated to changes in the cerebral metabolism.Methods Eight patients required carotid angiography for evaluation of transient neurological attacks. Cerebral blood flow (CBF) results, angiography, and clinical observations subsequently suggested the diagnosis: migraine with aura and occasional aura attacks without headache. In the same setting the cerebral angiography was followed by four to six repeated recordings of regional CBF using the intra-arterial Xe-133 injection method. Blood samples were drawn from the carotid artery and the internal jugular vein to measure oxygen extraction fraction and cerebral metabolic rate for oxygen.Results The intracarotid regional CBF technique provoked aura symptoms and typical, migraine-related, posterior focal hypoperfusion in four patients, followed by typical unilateral headache in three patients. The remaining four patients had no symptoms or regional CBF changes during the examination. There was a significant increase (mean, 13%) of global oxygen extraction fraction in the four patients during aura symptoms, whereas no significant changes of oxygen extraction fraction were found in the nonsymptomatic group. The increase in global oxygen extraction fraction in the symptomatic group coincided with a drop of hemispheric CBF (mean, 12%). Cerebral metabolic oxygen rate remained essentially unchanged, as did Paco(2).Conclusions The data presented suggest that the focal flow reduction during the migraine-aura phase is not a secondary phenomenon of reduced cerebral metabolism. However, arteriolar vasoconstriction might offer a possible explanation for the regional CBF changes observed during the migraine aura.