Assessment of Cerebral Hemodynamics to Acetazolamide Using Brain Perfusion SPECT in Cerebral Autosomal Dominant Arteriopathy With Subcortical Infarcts and Leukoencephalopathy

Park, Soon-Ah; Yang, Chung-Yong; Choi, See-Sung; Kim, Woo Hyoung

doi:10.1097/rlu.0b013e3182073c0f

Cited by 7 publications

(3 citation statements)

References 9 publications

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“…[57][58][59] Acetazolamide has also been suggested to improve overall cerebral hemodynamics in CADASIL, perhaps suggesting a protective effect, but this has also not been proven in controlled trials. 60,61 For acute treatment of migraine attacks, triptans and ergot derivatives should generally be avoided due to the high risk of stroke in these patients, and simple analgesics and non-steroidal anti-inflammatory drugs are preferred. 22 For secondary stroke prevention, antiplatelet agents should be used over anticoagulants due to high prevalence of cerebral microbleeds, which may suggest an increased risk of symptomatic intracerebral hemorrhage.…”

Section: Discussion Of Cerebral Autosomal Dominant Arteriopathy With mentioning

confidence: 99%

“…Acetazolamide has been anecdotally reported to be effective in the prophylaxis of migraine in CADASIL, but randomized, controlled trials are lacking 57‐59. Acetazolamide has also been suggested to improve overall cerebral hemodynamics in CADASIL, perhaps suggesting a protective effect, but this has also not been proven in controlled trials . For acute treatment of migraine attacks, triptans and ergot derivatives should generally be avoided due to the high risk of stroke in these patients, and simple analgesics and non‐steroidal anti‐inflammatory drugs are preferred …”

Section: Discussion Of Cerebral Autosomal Dominant Arteriopathy With mentioning

confidence: 99%

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Acute Postpartum Headache

2014

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Section: Discussion Of Cerebral Autosomal Dominant Arteriopathy With mentioning

confidence: 99%

Section: Discussion Of Cerebral Autosomal Dominant Arteriopathy With mentioning

confidence: 99%

Acute Postpartum Headache

2014

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“…In this disease, the drug is able to produce an increase in cerebral perfusion as seen by transcranial Doppler sonography [18], perfusion MRI [19] or Tc-99m ECD brain perfusion SPECT [20]. …”

Section: Discussionmentioning

confidence: 99%

Acetazolamide for the prophylaxis of migraine in CADASIL: a preliminary experience

et al. 2012

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Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is an inherited microangiopathy caused by NOTCH3 mutations. It is characterized by migraine, with or without aura, ischemic events, psychiatric and cognitive disturbances. There is no approved treatment for migraine prophylaxis in CADASIL, but acetazolamide has been anecdotally reported to be effective. We retrospectively reviewed our database of patients with a genetic diagnosis of CADASIL to identify how many of them were treated with acetazolamide for the prophylaxis of migraine. The efficacy and the tolerability of this treatment were checked looking at the clinic reports. Acetazolamide was prescribed in seven patients; the mean duration of treatment was 6 months, and the daily dose ranged from 125 to 500 mg. Three patients had a total and sustained remission, while in two patients a reduction in attacks and an improvement of the headache intensity were recorded. In one of these, acetazolamide was deliberately taken only during the migraine attack and the beneficial effect started 1 h after administration. In two patients, the drug did not produce any beneficial effect. Mild side effects were recorded in two patients. Our preliminary experience expands previous reports and confirms the possible efficacy of acetazolamide in CADASIL migraine. Based on these data, a randomized controlled trial seems worthy to be carried out to test the efficacy and safety of this drug.

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Migraine and Neurogenetic Disorders

Sathe

2013

Curr Pain Headache Rep

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In the current classification of headache disorders, headache attributable to genetic disorders is not classified separately, rather as headache attributed to cranial or cervical vascular disorder. The classification thus implies that a vascular pathology causes headache in these genetic disorders. Unquestionably, migraine is one of the prominent presenting features of several genetic cerebral small vessel diseases such as cerebral autosomal dominant arteriopathy with subcortical infarcts and leucoencephalopathy, retinal vasculopathy with cerebral leukodystrophy, and hereditary infantile hemiparessis, retinal arteriolar tortuosity and leukoencephalopahty. Shared genetic features, increased susceptibility, and/or vascular endothelial dysfunction may play a role in pathogenesis of migraine. Common or overlapping pathways involving the responsible genes may provide insight regarding the pathophysiological mechanisms that can explain their comorbidity with migraine. This review focuses on clinical features of genetic vasculopathies. An independent category-migraine related to genetic disorders-should be considered to classify these disorders.

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Assessment of Cerebral Hemodynamics to Acetazolamide Using Brain Perfusion SPECT in Cerebral Autosomal Dominant Arteriopathy With Subcortical Infarcts and Leukoencephalopathy

Cited by 7 publications

References 9 publications

Acute Postpartum Headache

Acute Postpartum Headache

Acetazolamide for the prophylaxis of migraine in CADASIL: a preliminary experience

Migraine and Neurogenetic Disorders

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