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November 1992

Migraine and Other Headaches: The Vascular Mechanisms

Author Affiliations

Kansas City, Kan

Arch Neurol. 1992;49(11):1110. doi:10.1001/archneur.1992.00530350020006

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This impressive book provides stateof-the-art knowledge concerning the vascular changes that occur in headache and their relationship to cerebral neuronal dysfunction (particularly "spreading depression") in the pathophysiology of the phenomenon of migraine. This is a narrow focus but one that is of great importance, particularly in migraine with aura. Separate sections of the book deal with experimental studies on migraine with aura, migraine without aura, cluster headaches, and a few of the other headache syndromes. In most sections, studies during attacks and in interictal periods are reported.

Several of the leading groups in the field present and discuss data using a wide variety of techniques, eg, xenon 133 inhalation, intracarotid xenon 133, single photon emission computed tomography, and transcranial Doppler ultrasonography. Limitations of each of these methods as they relate to migraine are frequently discussed. In the section on migraine with aura, the relationship of the pathophysiologic phenomenon of cortical

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