Postangiographische Sp�treaktionen der Hirngef��e bei Migr�ne-Kranken

Janzen, R. W. C.; Tänzer, A.; Zschocke, Stephan; Dieckmann, Herbert

doi:10.1007/bf00316720

Cited by 9 publications

(5 citation statements)

References 27 publications

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“…The intra-arterial procedure often triggers an attack in patients suffering from migraine with aura. Sometimes the symptoms start during the angiography, but more often up to one hour after (8,21,22,28,29). In our hands, attacks have been induced in approximately 70% of migraineurs.…”

Section: Discussionmentioning

confidence: 63%

Absence of Vasoactive Peptide Release from Brain to Cerebral Circulation During Onset of Migraine With Aura

et al. 1994

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In eight patients carotid angiography was required for evaluation of transient neurological attacks. Cerebral blood flow results, angiography and clinical observations subsequently suggested the diagnosis of migraine. We measured plasma concentrations of substance P(SP), neuropeptide Y (NPY), calcitonin gene-related peptide (CGRP) and vasoactive intestinal peptide (VIP) in repeated blood samples obtained from the carotid artery and the internal jugular vein in conjunction with cerebral angiography followed by 4 to 6 repeated recordings of regional cerebral blood flow (rCBF) with the intracarotid Xenon-133 injection technique. This technique is known to induce attacks of migraine with aura in many sufferers. Four patients developed aura symptoms. In three this was succeeded by throbbing headache. Typical, migraine-related, focal hypoperfusion occurred in conjunction with the aura symptoms. The remaining four patients had no symptoms or rCBF changes. There were no systematic or statistically significant changes over time in arterial-venous plasma concentrations or in the release rates of any of the peptides. All migraineurs had an overall elevated mean CGRP value compared to control values from the literature. The overall plasma levels of the potent vasoconstrictor NPY were higher (p < 0.10) in the group that developed symptoms and rCBF changes (136 pmol/l) than in the non-symptomatic group (97 pmol/l). The difference in NPY levels could perhaps be associated with the focal rCBF decrease seen in the attack group.

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Section: Discussionmentioning

confidence: 63%

Absence of Vasoactive Peptide Release from Brain to Cerebral Circulation During Onset of Migraine With Aura

et al. 1994

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“…6 Such vasoconstriction would have to be on the level of the resistance vessels (mainly arterioles), as angiographically significant hemodynamic spasms of the large arteries have been seen only in exceptional cases during migraine attacks. 7 Positron emission tomography would be the examination method of choice to study metabolic changes, but to our knowledge only one study of regional oxygen metabolism during migraine attacks in three patients has been performed. 8 Of these patients, only one was studied during the aura phase.…”

mentioning

confidence: 99%

Cerebral oxygen extraction, oxygen consumption, and regional cerebral blood flow during the aura phase of migraine.

Friberg

Olesen

Lassen

et al. 1994

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Background and PurposeThe 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 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

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“…Microembolization has successfully evoked recurrent CSDs in the mouse brain 47 . In humans, migraine has been demonstrated following contrast injection through a femoral artery catheter during vertebral angiography and after a carotid puncture, for the latter of which microembolization has been implicated as a possible cause in a mouse model 48,49 …”

Section: Discussionmentioning

confidence: 99%

“…47 In humans, migraine has been demonstrated following contrast injection through a femoral artery catheter during vertebral angiography and after a carotid puncture, for the latter of which microembolization has been implicated as a possible cause in a mouse model. 48,49 In the case of sclerotherapy, bubbles in the left heart have been demonstrated 1 min after injection, and microbubbles in the middle cerebral artery have been demonstrated using transcranial Doppler. 11 Additionally, a case report has revealed pathological evidence of paradoxical embolism with polidocanol foam in a patient treated with sclerotherapy.…”

Section: Potential Underlying Mechanismsmentioning

confidence: 99%

Migraine aura‐like episodes following sclerotherapy for varicose veins of the lower extremities—A systematic review

et al. 2023

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Objective: This systematic review provides a summary and evaluation of cases of migraine aura-like episodes elicited by sclerotherapy of veins of the lower extremities and discusses possible underlying mechanisms.Background: Sclerotherapy is a commonly used treatment for varicose veins.Symptoms resembling migraine aura have been reported during and following sclerotherapy of the lower extremities, suggesting that sclerotherapy may elicit migraine aura. Methods:We searched PubMed for articles reporting neurological complications that were transient and fully reversible following sclerotherapy treatment for varicose veins in the lower limbs. There were no restrictions regarding article language or publication date. Only original studies and case reports were included. Two authors independently reviewed included articles in detail. Data were extracted from each article, including details on symptoms, previous migraine history, sclerotherapy method, and the presence of a right-to-left cardiac shunt in patients. We evaluated whether episodes fulfilled modified International Classification of Headache Disorders, 3rd edition, criteria for 1.2 Migraine with aura or 1.5.2 Probable migraine with aura. Results:The search yielded 777 articles, 28 of which were included. Twenty-six articles reported 119 episodes of transient neurological symptoms in 34,500 sclerotherapy sessions. Two additional articles reported six episodes of transient neurological symptoms with no specification of the number of sessions. Of the 125 episodes, 119 involved transient visual disturbances, and eight met the modified criteria for Probable migraine with aura. In most episodes (98%), clinical information was insufficient to determine if the criteria were fulfilled.Conclusions: Symptoms that are clinically indistinguishable from migraine with aura attacks may occur following sclerotherapy, although this likely is rare. Microembolization through a right-to-left shunt triggering cortical spreading depolarization is a possible mechanism. Our findings are limited by infrequent specific assessments for

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Postangiographische Sp�treaktionen der Hirngef��e bei Migr�ne-Kranken

Cited by 9 publications

References 27 publications

Absence of Vasoactive Peptide Release from Brain to Cerebral Circulation During Onset of Migraine With Aura

Absence of Vasoactive Peptide Release from Brain to Cerebral Circulation During Onset of Migraine With Aura

Cerebral oxygen extraction, oxygen consumption, and regional cerebral blood flow during the aura phase of migraine.

Migraine aura‐like episodes following sclerotherapy for varicose veins of the lower extremities—A systematic review

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