摘要:

SYNOPSISThe present study reports cerebral blood flow (CBF) measurements in 11 patients during attacks of classic migraine (CM)‐migraine with aura. In 6 and 7 patients, respectively, cerebral vascular reactivity to increased blood pressure and to hypocapnia was also investigated during the CM attacks. The Xenon‐133 intraarterial injection technique was used to measure CBF. In this study, based in part on previously published data, methodological limitations, in particular caused by scattered radiation (Compton scatter), are critically analysed. Based on this analysis and the results of the CBF studies it is concluded:During CM attacks CBF appears to decrease focally in the posterior part of the brain to a level around 20 ml/100 g/min which is consistent with a mild degree of ischemia. Changes of CBF in focal low flow areas are difficult to evaluate accurately with the Xe‐133 technique. In most cases true CBF may change 50% or more in the low flow areas without giving rise to significantly measurable changes of CBF. This analysis suggests that the autoregulation response cannot be evaluated in the low flow areas with the technique used while the observations are compatible with the concept that a vasoconstrictive state, unresponsive to hypocapnia, prevails in the low flow areas during CM attacks.The gradual increase in size of the low flow area seen in several cases may be interpreted in two different ways. A spreading process may actually exist. However, due to Compton scatter, a gradual decrease of CBF in a territorythat does not increase in size will also appear as a gradually spreading low flow area when studied with the Xe‐133 intracarotid te

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1989.hed2901015.x

出版商:Blackwell Science Inc    

年代:1989

数据来源: WILEY

摘要:

SYNOPSISThe efficacy and tolerance of 20 mg flunarizine i.v. were tested in comparison with placebo in a multicentre randomised double‐blind trial in the acute treatment of migraine attacks. Sixty case reports were included in theevaluation; 31 patients were treated with flunarizine and 29 with placebo. Flunarizine proved to be significantly superior in its effect on the intensity of pain and the typical concomitant symptoms of the attacks. Patients were classed as responders who displayed a reduction in pain intensity by at least 50% within 60 minutes after the administration of flunarizine. 23 patients (= 74.2%) were responders, including 11 patients being without pain after60 minutes. In the placebo group the responder rate was 27.6%. The fact that both groups were comparable in all respects should be emphasized. The tolerance of intravenously administered flunarizine was excellent and corresponded to that of placebo. Apart from a sedative effect reported by 9 patients there were no side‐effects. The circulatory conditions remained largely stable. The result of this study seems to indicate that an intravenous injection of 20 mg flunarizine might represent a genuine alternative, and as regards tolerance even a superior one, to the parenteral administration of ergotamine in migraine atta

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1989.hed2901021.x

出版商:Blackwell Science Inc    

年代:1989

数据来源: WILEY

摘要:

SYNOPSISWe used transmission electron microscopy to investigate selected aspects of the platelet response (surface activation as well as aggregation) and quantify cytoplasmic organelles within the cytoplasm of platelets obtained from both healthy control women and women diagnosed as having either common or classic migraine. Comparisons between controls and migraineurs showed no differences for: (1) the number of circulating platelets, (2) degree of surface activation, (3) amount of aggregate formation or (4) percent of hyperactive platelet populations. In contrast, platelets of migraine sufferers uniformly containeda significantly greater number of dense bodies compared to control platelets. Although we did not find functional abnormalities for the platelets obtained from migraineurs, we did demonstrate that they were altered structurally.

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1989.hed2901028.x

出版商:Blackwell Science Inc    

年代:1989

数据来源: WILEY

摘要:

SYNOPSISThe purpose of this investigation was to evaluate the long‐term course of non‐invasively treated chronic headache. A total of 1015 adult patients with primary diagnosis of vascular/ migraine or muscle contraction headache participated in the study investigating symptom frequency and severity over a 36 month period after receiving treatment. Treatment consisted of either: relaxation training (stepwise relaxation/hypnosis/ autogenic training/cognitive behavior therapy); biofeedback (thermal/photoplethysmograph/EMG); micro‐electrical therapy (TENS/Neurotransmitter Modulation) or multimodal treatment (combination of any of the above two treatments). Seven hundred and ninety‐three patients returned sufficient data to be included in the analysis. Patients were randomly assigned to treatment groups and received either short term intervention (15 or less treatments) or long term intervention (greater than 15 treatments). Results indicate that all treatment conditions significantly reduced frequency and intensity of cephalalgia. Repeated measure analysis of variance indicated that grouping variables of Biofeedback treatment, symptoms being evidenced less than 2 years and receiving over 15 treatment sessions best predicted successful inter

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1989.hed2901034.x

出版商:Blackwell Science Inc    

年代:1989

数据来源: WILEY

摘要:

SYNOPSISAnti‐phospholipid antibodies (APA), initially described with SLE, have in recent years received much attention because of an associated increased risk of thrombo‐embolic disease, recurrent abortion and thrombocytopenia. Although commonly seen with SLE or other collagen vascular diseases, the antibodies frequently occur in the absence of any such disease. Neurologic complications include transient or permanent ischemic episodes, migraine or related phenomena, myelopathy and a Guillain‐Barré type syndrome.In this report we describe the presenting features and clinical course of six patients with anti‐phospholipid antibodies where migraine was an early and prominent symptom. All six patients, however, were recognized only after a second more serious event had occurred. As this entity becomes more widely recognized and better treatments evolve an earlier diagnosis of patients with migraine as the only manifestation of APA may prevent the development of other serious compl

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1989.hed2901042.x

出版商:Blackwell Science Inc    

年代:1989

数据来源: WILEY

摘要:

SYNOPSISHistamine release and leukotrienes (LTB4and LTC4) production from circulating basophils have been studied in 13 patients with episodic cluster headache (CH) during the remission phase of symptoms, and in 9 normal subjects. Cell suspensions of basophils were stimulated with scalar dilutions of anti‐lgE, f‐met‐peptide and Ca2+ionophore A23187. Histamine was measured by an automated fluorimetric method; LTB4and LTC4with RIA in individual cases, and with Reverse‐Phase HPLC in the two pools obtained from the supernatants of CH patients and controls. Mean values of histamine release in patients with CH were significantly lower when compared to those obtained in control subjects after stimulation with anti IgE at the three dilutions used. LTC4mean levels measured in CH patients were significantly lower than those of supernatants from controls after stimulation with 0.05 /ml of A23187. A reduction of LTC4and LTB4levels in CH patients was also observed in R‐P HPLC, which showed different elution patterns in the two groups. The histamine release in individual cases was related to leukotriene production: LTC 4 levels were significantly (p<.05) higher in “high histamine releasers” than in “low histamine releasers”. Our results indicate that CH patients have complex abnormalities of histamine release and of leukotriene production during the painless pha

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1989.hed2901046.x

出版商:Blackwell Science Inc    

年代:1989

数据来源: WILEY

摘要:

SYNOPSISA group of 350 migraineurs (87 male, 263 female) and 300 controls without migraine (104 male, 196 female) were questioned about occurrence, in parents, of the atherosclerosis‐related diseases (ASRD) of diabetes mellitus (DM), hypertension (HBP), myocardial infarction (MI), and stroke as well as about recurrent severe headache (RSHA). Occurrence of DM, HBP, MI and stroke was compared for mothers and fathers of migraine vs. those of control subjects and no significant differences were found. The mothers and fathers were pooled and resegregated by presence or absence of RSHA and then occurrence of DM, HBP, MI and stroke again compared. For mothers there was increased occurrence of stroke and DM in the RSHA group but the differences were not significant. For RSHA fathers there was increased incidence of MI (p<.10) and HBP (p<.01). Aggregate occurrence of all ASRD was evaluated for RSHA vs. no‐RSHA parents. ASRD occurred more frequently in the RSHA than in the no‐RSHA parents (p<.05). Breakdown by age showed that this occurred at all ages in men (p<.05) but in women the difference was significant only under age 60 (p<.05). This study suggests that RSHA, which is primarily migraine, may be a risk factor or a marker for occurrence of

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1989.hed2901049.x

出版商:Blackwell Science Inc    

年代:1989

数据来源: WILEY

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1989.hed2901055.x

出版商:Blackwell Science Inc    

年代:1989

数据来源: WILEY

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1989.hed2901059_2.x

出版商:Blackwell Science Inc    

年代:1989

数据来源: WILEY

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1989.hed2901059_3.x

出版商:Blackwell Science Inc    

年代:1989

数据来源: WILEY