“…Human studies have shown that the aura phase of migraine is associated with biphasic changes in cortical blood flow (initial hyperemia followed by sustained oligemia) that propagate throughout the surface of the visual cortex (Lauritzen and Olesen, 1984; Cao et al, 1999; Hadjikhani et al, 2001). The going theory is that ATP as well as glutamate, potassium, and hydrogen ions are released locally during the hyperemic phase of the CSD by neurons, glia (Brinley et al, 1960; Rapoport and Marshall, 1964; Csiba et al, 1985; Marrannes et al, 1988; D’Andrea et al, 1991; Lauritzen and Hansen, 1992; Fabricius et al, 1993; Mayevsky et al, 1996; James et al, 2001; Schock et al, 2007; Charles and Brennan, 2009) or vascular cells (Brennan et al, 2007). Regardless of the origin of their release, these mediators diffuse outward into the leptomeninges overlaying the affected cortical region, resulting in activation of pial nociceptors, local neurogenic inflammation and the persistent activation of dural nociceptors which triggers the migraine headache (Moskowitz, 1993).…”