Regional cerebral blood flow (rCBF) was studied using the xenon Xe 133 intra-arterial injection method during a long-lasting preheadache phase of a migraine attack. The patient was hyperventilating moderately, rCBF was markedly reduced, and the reduction was uniform throughout the hemisphere. (Hyperventilation could not account for the rCBF reduction.) Increase of arterial carbon dioxide pressure by the inhalation of a carbon dioxide mixture did not change rCBF. (Normally a marked rCBF increase is seen.) At the end of the study, papaverine was injected into the internal carotid artery; flow increase was observed, but the patient's preheadache phase now seemed to end gradually. Whether papaverine had a vasodilator effect in the preheadache phase remains unknown. The patient was restudied when asymptomatic, and rCBF and its regulation were normal.
Simard D, Paulson OB. Cerebral Vasomotor Paralysis During Migraine Attack. Arch Neurol. 1973;29(4):207–209. doi:10.1001/archneur.1973.00490280019001
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