SYNOPSIS
The activity of various blood clotting systems was measured during attacks of migraine complicated by prolonged focal cerebral dysfunction and contrasted with those observed when the same and other patients had uncomplicated migraine. Results differed in the two groups.
In patients with complicated migraine, plasma coagulability rose during both complicated and uncomplicated attacks. During a complicated migraine attack, platelet aggregability to ADP also rose in all but one patient. Platelet aggregability fell in the same patients when they had uncomplicated migraine. Plasma coagulability consistently increased more when the headache was associated with focal cerebral dysfunction.
In patients with uncomplicated migraine, plasma coagulability dropped during the later phase of their attacks. This finding may reflect the release of endogenous heparin from mast cells and basophilic leucocytes. Platelet aggregability to ADP decreased in some but rose in others.
The results support the hypothesis that prolonged focal cerebral dysfunction may reflect thromboembolic phenomena. The influence of estrogens and genetic factors on clotting systems is reviewed.