Features of Hemodynamics in Head Magistral and Cerebral Arteries in the Patients With Migraine

Abstract

The aim of the study was to Doppler sonography study of the structural and functional state of head magistral arteries (HMA) and cerebral arteries in the patients with various forms of migraine. Materials and methods: We conducted the clinical Doppler examination of 124 young patients (18-45 years old), including 55 men and 69 women in the conditions of the clinical base of the Kharkiv Medical Academy of Postgraduate Education in 2017-2019. The criteria for involvement of patients in the study were: migraine without aura (group 1 – 63 patients), migraine with aura (group 2 – 61 patients) The control group consisted of 45 patients of the corresponding gender and age. The condition of HMA and cerebral arteries was studied using the ultrasound device. Results: The presence of extravasal compressions of vertebral arteries (VA) is typical for the patients with migraine, as well as for some cases of the hypoplasia of the VA in the group of the patients with migraine with aura. In the patients with migraine with aura, there was a decrease in the velocity values in the extracranial VA segments. The velocity values in the external carotid arteries (ECA) were slightly reduced in both groups. The most significant were the changes in the hemodynamics in the middle cerebral arteries (MCA), which were manifested by the pattern of the excessive perfusion in the patients of the migraine without aura and the pattern of the hampered perfusion in the MCA in the patients of the migraine with aura. Conclusions: 1. In the patients with migraine with aura, a decrease in the velocity values in the extracranial segments of the VA was observed, in some cases combined with the hypoplasia of the vertebral artery, the hampered perfusion in middle cerebral arteries. 2. The excessive perfusion in middle cerebral arteries is the most critical hemodynamic pattern in the patients with migraine without aura. 3. The extravasal compression of vertebral arteries, combined with the hyperperfusion in posterior cerebral arteries, is a typical hemodynamic pattern both in the group of the patients with migraine with aura, and in the group of the patients with migraine without aura.

The Comparison of Pulsatility Index, Resistance Index, and Diameter of the Temporal, Carotid, and Vertebral Arteries During Active Migraine Headaches to Non-Headache Intervals

“…17,23 The present study results did not demonstrate a significant difference in the PSV within the ECA, between active migraines and symptom-free intervals. This was in contrast with the findings by Kalashnikov et al 29 that showed significantly lower velocity of the artery during active headaches.…”

“…In most of the abovementioned studies, only a few extracranial arteries were studied. [22][23][24][25][26][27][28][29][30] Given the fact that migraine is a debilitating disease, which can significantly reduce the quality of life, especially among teenagers and young people, the objective was to assess vertebral arteries, superficial temporal arteries, ICAs, external carotid arteries (ECAs), and common carotid arteries (CCAs) of patients with migraine disease, using sonography. By comparing the diameter of arteries, pulsatility index (PI), resistive index (RI), and peak systolic velocity (PSV), during migraine headache attacks and nonheadache intervals, the aim was to gain a better understanding of the vascular changes during active headaches.…”