Using the intracarotid xenon Xe 133 clearance method for determination of regional blood flow within the internal carotid area, we examined four patients during the prodromal phase of migraine. They all showed a severely reduced perfusion, in some areas to a level known to be critical for an adequate oxygenation. Six patients examined during the headache phase showed a significant hyperperfusion. As a possible cause of this hyperperfusion, an intracerebral lactate-acidosis was found in all cases, indicating that even common migraine is preceeded by a subclinical cerebral hypoxia. Angiographic studies during the prodromal phase support the hypothesis that vascular dysregulation in the basilar artery, as well as in the carotids, play a substantial role in the pathogenesis of migraine.
Skinhøj E. Hemodynamic Studies Within the Brain During Migraine. Arch Neurol. 1973;29(2):95–98. doi:10.1001/archneur.1973.00490260039007
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