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Nuklearmedizin 1990; 29(05): 210-214
DOI: 10.1055/s-0038-1629533
Deutsche Gesellschaft für Nuklearmedizin
Schattauer GmbH

Cerebral Blood Flow and Volume in Symptom-Free Migraineurs: a SPECT Study

C. L. Maini
1   From the Chair of Nuclear Medicine, University of Ancona, Italy
,
G. L. Turco
2   the Chair of Nuclear Medicine, University of Torino, Italy
,
G. Castellano
2   the Chair of Nuclear Medicine, University of Torino, Italy
,
W. Liboni
3   the Department of Neurology, University of Torino, Italy
,
V. Podio
2   the Chair of Nuclear Medicine, University of Torino, Italy
,
G. Chianale
3   the Department of Neurology, University of Torino, Italy
,
G. Cornaglia
2   the Chair of Nuclear Medicine, University of Torino, Italy
› Institutsangaben
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Publikationsverlauf

Received: 28. Februar 1990

in revised form: 27. April 1990

Publikationsdatum:
04. Februar 2018 (online)

    Lizenzen und Reprints

Both CBF and CBV were evaluated by gamma-camera SPECT in 14 patients with classic migraine, all studied while symptom-free. Nuclear data were correlated with CT and MRI. A decreased regional CBF was observed in 13 of the 14 patients. The decreased perfusion was localized in the frontal lobe in 6 patients, the temporal lobe in one, the parietal lobe in 11 and the occipital lobe in 5 patients. The parieto-occipital cortex was involved more often than the frontal cortex; the association of hypoperfusion with parieto-occipital cortex was quite high. The right parieto-occipital regions were affected more often than the left ones. Regional CBV was increased in 8 patients. There was good topographical concordance between decreased CBF and increased CBV, but the increase of CBV was in general more evident at the periphery of the hypoperfusion. It is of interest that the only patient with a normal CBF study had a pathological CBV study. Apparently, CBF derangements are very common in symptom-free patients with classic migraine, a CBF decrease being often accompanied by a CBV increase. In these patients both CT and MRI have a lower diagnostic yield than SPECT.

Zusammenfassung

Die CBF- und CBV-SPECT (rotierende Gammakamera) wurde bei 14 Patienten mit klassischer Migräne eingesetzt. Alle Patienten wurden im symptomfreien Intervall untersucht und die Ergebnisse mit CT und KST korreliert. Bei 13 dieser Patienten wurde eine verminderte regionale Hirndurchblutung beobachtet. Diese war bei 6 Patienten frontal, bei einem temporal, bei 11 parietal und bei 5 Patienten okzipital lokalisiert. Der parieto-okzipitale Kortex war signifikant häufiger beteiligt als der frontale Kortex. Die Verknüpfung einer Hypoperfusion mit dem parieto-okzipitalen Kortex war statistisch zu sichern. Die rechte parieto-okzipitale Region war häufiger betroffen als die linke. Das regionale Blutvolumen war bei 8 Patienten erhöht. Es ergab sich eine gute topographische Übereinstimmung von vermindertem Fluß und Erhöhung des Volumens, die häufiger in der Peripherie der Hypoperfusion zu finden war. Der einzige Patient mit normaler Hirndurchblutung hatte ein erhöhtes Volumen. Offenbar sind bei symptomfreien Patienten mit klassischer Migräne Störungen der regionalen Hirndurchblutung relativ häufig, wobei eine Verminderung der Hirndurchblutung häufig von einer Erhöhung des Blutvolumens begleitet ist. Bei diesen Patienten war der diagnostische Beitrag von CT und KST geringer als jener der SPECT.

 

  • REFERENCES

  • 1 Ad Hoc Committee on Classification of Headache. J Am Med Ass. 1962; 179: 717-8.
    Google Scholar
  • 2 Blalock jr H M. Social statistics. New York: Mac-Graw Hill; 1979
    Google Scholar
  • 3 Böttger I G, Lottes G, Schlake H P, Grotemeyer K H. 123I-IMP-SPECT imaging of cerebral perfusion in the pain-free interval of classic migraine. J Cereb Blood Flow Metab 1987; 07 (Suppl. 01) S21-2.
    CrossrefPubMedGoogle Scholar
  • 4 Broderick J P, Swanson J W. Migrainerelated strokes; clinical profile and prognosis in 20 patients. Arch Neurol 1987; 44: 868-71.
    CrossrefPubMedGoogle Scholar
  • 5 Buell U, Stirner H, Braun H, Kreiten K, Febert A. SPECT with 99Tcm-HMPAO and 99Tcm-pertechnetate to assess regional cerebral blood flow (rCBF) and blood volume (rCBV). Preliminary results in cerebrovascular disease and interictal epilepsy. Nucl. Med Comm 1987; 08: 519-24.
    Google Scholar
  • 6 Buell U, Braun H, Ferbert A. et al. Combined SPECT imaging of regional cerebral blood flow (99mTc-hexamethyl-propylencamine oxime, HMPAO) and blood volume (99mTc-RBC) to assess regional cerebral perfusion reserve in patients with cerebrovascular disease. Nucl-Med 1988; 27: 51-6.
    Google Scholar
  • 7 du Boulay G H, Ruiz J S, Rose F C, Stevens J M, Zilkha K J. CT changes associated with migraine. Am J Neuroradiol 1983; 04: 472-3.
    Google Scholar
  • 8 Featherstone H J. Clinical features of stroke in migraine: a review. Headache 1986; 26: 128-33.
    CrossrefPubMedGoogle Scholar
  • 9 Gowers W R. The borderland of epilepsy. London: J & A Churchill; 1907
    Google Scholar
  • 10 Hart G H, Miller V T. Cerebral infarction in young adults: a practical approach. Stroke 1983; 14: 110-4.
    CrossrefPubMedGoogle Scholar
  • 11 Kaplan R D, Solomon G D, Diamond S, Freitag F G. The role of MRI in the evaluation of a migraine population: preliminary data. Headache 1987; 27: 315-8.
    CrossrefPubMedGoogle Scholar
  • 12 Lagrèze H L, Tsuda Y, Hartman A, Bulau P. Effect of flunarizine on regional cerebral blood flow in common and complicated migraine. Eur Neurol 1986; 25 (Suppl. 01) 122-6.
    CrossrefPubMedGoogle Scholar
  • 13 Lagrèze H L, Dettmers C, Hartmann A. Abnormalities of interictal cerebral perfusion in classic but not common migraine. Stroke 1988; 19: 1108-11.
    CrossrefPubMedGoogle Scholar
  • 14 Laurizen M, Olsen T S, Larsen N A, Paulson O B. Regulation of regional cerebral blood flow during and between migraine attacks. Ann Neurol 1983; 14: 569-72.
    CrossrefPubMedGoogle Scholar
  • 15 Laurizen M. Cerebral blood flow in migraine and cortical spreading depression. Acta Neurol Scand 1987; 76 (Suppl. 113) 1-40.
    PubMedGoogle Scholar
  • 16 Leäo A A P, Morrison R S. Propagation of cortical spreading depression. J Neurophysiol 1945; 08: 33-45.
    CrossrefGoogle Scholar
  • 17 Levine S R, Welch K M A, Ewing J R, Joseph R, D’Andrea G. Cerebral blood flow asymmetries in headache-free migraineurs. Stroke 1987; 18: 1164-5.
    CrossrefPubMedGoogle Scholar
  • 18 Mathew N T, Meyer J S, Welch K M A, Neblett C R. Abnormal CT scan in migraine. Headache 1977; 16: 272-9.
    CrossrefPubMedGoogle Scholar
  • 19 Nemoto E M, Snyder J V, Carroll R G, Morita H. Global ischemia in dogs: cerebrovascular CO2 reactivity and autoregulation. Stroke 1975; 06: 425-31.
    CrossrefPubMedGoogle Scholar
  • 20 Olsen T S, Friberg L, Lassen N A. Ischemia may be the primary cause of the neurologic deficits in classic migraine. Arch Neurol 1987; 44: 156-61.
    CrossrefPubMedGoogle Scholar
  • 21 Peatfield P C. Can transient ischemic attacks and classical migraine always be distinguished?. Headache 1987; 27: 240-3.
    CrossrefPubMedGoogle Scholar
  • 22 Rothrock J F, Walicke P, Swenson M R, Lyden P D, Logan W R. Migrainous stroke. Arch Neurol 1988; 45: 63-7.
    CrossrefPubMedGoogle Scholar
  • 23 Sachs H, Russell JAG, Christman D R, Fowler J S, Wolf A P. Positron emission tomographic studies on induced migraine. Lancet 1984; 01: 465.
    Google Scholar
  • 24 Sakai F, Mayer J S. Abnormal cerebrovascular reactivity in patients with migraine and cluster headache. Headache 1979; 19: 257-66.
    CrossrefPubMedGoogle Scholar
  • 25 Sargent J D, Lawson R C, Solbach P, Coyne L. Use of CT scan in an out-patient headache population: an evaluation. Headache 1979; 19: 388-90.
    CrossrefPubMedGoogle Scholar
  • 26 Shah A B, Coull B M, Beamer N B. In vivo platelet activation and strokes in young adults with migraine. Neurology 1983; 33 (Suppl. 02) 206.
    Google Scholar
  • 27 Simard D, Paulson O B. Cerebral vasomotor paralysis during migraine attack. Arch Neurol 1973; 29: 207-9.
    CrossrefPubMedGoogle Scholar
  • 28 Soges L J, Cacayorin E D, Petro G R, Ramachandran T S. Migraine: evaluation by MR. Am J Neuroradiol 1988; 09: 425-9.
    Google Scholar
  • 29 Wolff H G. Headache and other head pain. Oxford: University Press; 1963
    Google Scholar