Shirai T, Meyer J S, Akiyama H, Mortel K F, Wills P M
Department of Neurology, Baylor College of Medicine, Houston, Tex, USA.
Headache. 1996 Nov-Dec;36(10):589-94. doi: 10.1046/j.1526-4610.1996.3610589.x.
Cerebrovascular capacitance was tested by measuring local cerebral blood flow (LCBF) by xenon-contrasted CT scanning before and after the oral administration of 14.3 mg/kg of acetazolamide among 45 subjects including 15 age-matched controls without history of headache, 20 migraineurs with and without aura, 3 patients with cluster headache, and 7 patients with tension-type headache. Percentage increases of LCBF were measured in 10 regions located throughout both hemispheres. Laterality indices for asymmetric LCBF increases were calculated. Local cerebral blood flow in cortical gray matter increased 5.9% in controls, 9.9% in patients with tension headaches, but 18.6% in both migraine and cluster headache patients; significantly greater LCBF increases than among controls or among patients with tension headaches (P < 0.05). Increases in LCBF were significantly asymmetric among migraine and cluster patients and provoked typical unilateral vascular headaches which responded to sumatriptan. Maximal asymmetric LCBF increases also corresponded to the reported side of the induced headaches confirming their vascular pathogenesis. Patients with tension headaches and controls without history of headache did not develop head pain after acetazolamide.
在45名受试者中，通过氙增强CT扫描测量口服14.3mg/kg乙酰唑胺前后的局部脑血流量（LCBF），以此来测试脑血管容量。这45名受试者包括15名无头痛病史的年龄匹配对照组、20名有或无先兆的偏头痛患者、3名丛集性头痛患者和7名紧张型头痛患者。在整个大脑半球的10个区域测量LCBF的增加百分比。计算不对称LCBF增加的侧别指数。皮质灰质中的局部脑血流量在对照组中增加了5.9%，在紧张型头痛患者中增加了9.9%，但在偏头痛和丛集性头痛患者中均增加了18.6%；LCBF的增加显著高于对照组或紧张型头痛患者（P<0.05）。偏头痛和丛集性头痛患者中LCBF的增加显著不对称，并引发典型的单侧血管性头痛，对舒马曲坦有反应。最大不对称LCBF增加也与诱发头痛的报告侧相对应，证实了它们的血管发病机制。紧张型头痛患者和无头痛病史的对照组在服用乙酰唑胺后未出现头痛。
