The Study Of Cerebral Blood Flow Measured By SPECT During Migraine Attacks

Objective: Observing the regional cerebral blood flow (rCBF) during migraine attacks and the changes after treatment with flunarizine HCI, to explore the etiopathogenesis of migraine and the available values of SPECT in the migraine .Methods: Brain SPECT was performed during migraine attacks for Twenty-two patients who were diagnosed with migraine according to the diagnostic criteria of the International Headache Society(HIS) published in 1988. After the compute collected and managed the patients'information, three experienced nuclear medicine physicians did visual interpretation and semiquantitative evaluation for images. The SPECT images were evaluated with regard to (1) the relationship between the areas of brain perfusion abnormality and the site of headache; (2)the asymmetry of the rCBF between the headache side and the nonheadache side; (3) the relationship among the rCBF scores (grade -3to7) and the seriousness (grade0to10) and frequencies of headache. The intensity of pain was scored on a visual analog scale (VAS) in which 0 represented no pain and 10 meant the worst pain imaginable. The patients were divided into three group by the intensity and frequency of pain. Brain SPECT was performed during headache-free periods for six patients who were treated with flunarizine HCI after two months, The rCBF observed in headache-free periods was compared with that during attacks.Results: (1)During attacks, hypoperfusion was observed in 82% of patients include 9 cases with migraine with aura(100%), 9 cases with migraine without aura(70%); (2)Low-flow areas were related with the site of pain; (3)For the patients who had unilateral headache, the rCBF between the headache side and the nonheadache side had significant differences, especially in the frontal,temporal,parietal(;4)The hypoperfusion degree of rCBF was not positive related to the severity and frequency of headache. (5) After treatment with flunarizine HCI , the hypoperfusion was showed normal in two cases , mend in three cases and unchanged in one cases.Conclusion:(1)Etiopathogenesis of migraine without auro may be same with the that of migraine with auro during migraine attacks. (2) An impaired regional cerebral vascular autoregulation may exist even during headache-free in patients suffering from migraine, the phenomena may be one of primary conditions which lead to headache recurrence and primary cause which conduced cerebral white matter lesion (WMLs) in migraineurs; (3) The changes in rCBF may be not a primary event but are secondary to Cortical spreading depression(CSD)。(4)Compared with CT,MRI,TCD ,SPECT can reflect the function of cerebral neurone during different periods and have more important value in the diagnosis and the treatments of migraine...