Zanette E M, Agnoli A, Roberti C, Chiarotti F, Cerbo R, Fieschi C
Department of Neurological Sciences, University La Sapienza, Rome, Italy.
Stroke. 1992 May;23(5):680-5. doi: 10.1161/01.str.23.5.680.
Our aim in this study was to compare headache-free and spontaneous migraine measurements of blood flow velocity and the pulsatility index in the anterior cerebral artery, middle cerebral artery, and posterior cerebral artery.
Thirty-one patients (nine having experienced migraine with aura and 22 migraine without aura) were studied in headache-free periods and during spontaneous migraine attacks with transcranial Doppler ultrasonography.
During attacks of migraine with aura, blood flow velocities (particularly the diastolic velocity [p = 0.05]) were reduced while the pulsatility index increased (p = 0.05), whereas a generalized increase in diastolic velocity (p less than 0.02) and a decrease in the pulsatility index (p = 0.05) were observed during attacks of migraine without aura. Significant variations of blood pressure and heart rate were never found.
These findings are consistent with constriction of resistance vessels in migraine with aura and dilatation of the vessels in migraine without aura. This disparity could be due to a difference between the two migraine types or could be related to the fact that in this study the time interval between headache onset and transcranial Doppler was shorter in the migraine-with-aura group. The latter explanation would apply if, in fact, both types of migraine evolve from hypoperfusion to hyperperfusion during their time course, although perhaps with a difference in intensity.
本研究的目的是比较大脑前动脉、大脑中动脉和大脑后动脉在无头痛期和自发性偏头痛发作时的血流速度及搏动指数。
对31例患者（9例有先兆偏头痛，22例无先兆偏头痛）在无头痛期和自发性偏头痛发作时进行经颅多普勒超声检查。
有先兆偏头痛发作时，血流速度（尤其是舒张期速度[p = 0.05]）降低，而搏动指数增加（p = 0.05）；无先兆偏头痛发作时，观察到舒张期速度普遍增加（p < 0.02），搏动指数降低（p = 0.05）。未发现血压和心率有显著变化。
这些发现与有先兆偏头痛时阻力血管收缩、无先兆偏头痛时血管扩张一致。这种差异可能是由于两种偏头痛类型不同，也可能与本研究中有先兆偏头痛组头痛发作至经颅多普勒检查的时间间隔较短有关。如果事实上两种类型的偏头痛在病程中均从灌注不足发展为灌注过度，只是强度可能有所不同，那么后一种解释是成立的。
