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October 1973

Cerebral Vasomotor Paralysis During Migraine Attack

Author Affiliations

From the Department of Neurological Sciences, Hôpital de L' Enfant Jésus, Laval University, Quebec. Dr. Paulson is a resident in Neurology, Mayo Graduate School of Medicine (University of Minnesota), Rochester.

Arch Neurol. 1973;29(4):207-209. doi:10.1001/archneur.1973.00490280019001

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.

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