The research of the late Harold G. Wolff and his colleagues established that the symptoms of migraine are linked closely with reactions of the cranial blood vessels. The main contribution to the pain of migraine headache comes from excessive dilatation of the scalp arteries, although the cerebral vessels may follow suit in some patients. The focal neurological symptoms of migraine are associated with constriction of the cerebral arteries which may initiate more subtle metabolic changes in cortical cells.
What mechanism maintains normal tonic vasoconstriction of scalp vessels and how is this disordered in migraine? It is unlikely to be a neural mechanism since scalp nerves exert a predominantly vasodilator action on extracranial arteries, and operations on sympathetic and parasympathetic nerve pathways have not provided lasting relief of migraine. Two communications in the May issue of the Archives of Neurology demonstrate that serotonin exerts a potent constrictor effect upon extracranial arteries
PLASMA SEROTONIN AND MIGRAINE HEADACHE. JAMA. 1967;200(6):549. doi:10.1001/jama.1967.03120190175032
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