Thie A, Fuhlendorf A, Spitzer K, Kunze K
Neurologische Universitätsklinik Eppendorf, Hamburg, Federal Republic of Germany.
Headache. 1990 Mar;30(4):209-15. doi: 10.1111/j.1526-4610.1990.hed3004209.x.
Transcranial Doppler (TCD) examinations were performed in 13 patients with common and 5 patients with classic migraine during attacks and compared to TCD findings during the headache-free period. Two distinct patterns of flow changes were detected to distinguish common from classic migraine on the basis of TCD findings. During attacks, patients with common migraine exhibited reduction of flow velocities associated with an increase of pulse wave amplitudes. Vascular bruits that were heard during the headache-free interval often disappeared. Opposite changes were found in attacks of classic migraine during the headache phase with increase of flow velocities, decrease of pulsatility and more prominent or newly appearing bruits. These findings were often diffuse and did not appear to correlate with side of headache or side of neurological aura. Uniform changes occurred in the cervical internal carotid artery and the basal cerebral arteries in either form of migraine. We propose that these changes represent caliber fluctuations of the large arteries, suggesting vasodilatation during attacks of common migraine and vasoconstriction during attacks of classic migraine. We do not intend to imply a casual role of these preliminary findings in migraine pathogenesis, but we suggest that TCD be used in combination with other methods to study vascular changes in migrainous disorders.
对13例普通型偏头痛患者和5例典型偏头痛患者在发作期进行经颅多普勒（TCD）检查，并与无头痛期的TCD检查结果进行比较。根据TCD检查结果，检测到两种不同的血流变化模式，以区分普通型偏头痛和典型偏头痛。在发作期，普通型偏头痛患者表现为血流速度降低，同时脉搏波振幅增加。在无头痛间期听到的血管杂音常常消失。在典型偏头痛发作的头痛期则发现相反的变化，即血流速度增加、搏动性降低以及更明显或新出现的杂音。这些发现往往是弥漫性的，似乎与头痛侧或神经学先兆侧无关。在两种类型的偏头痛中，颈内动脉和脑基底动脉均出现一致的变化。我们认为这些变化代表大动脉的管径波动，提示普通型偏头痛发作时血管扩张，典型偏头痛发作时血管收缩。我们并非暗示这些初步发现与偏头痛发病机制存在因果关系，但我们建议将TCD与其他方法结合使用，以研究偏头痛性疾病中的血管变化。
