CEREBROVASCULAR REACTIVITY MEASURED BY TRANSCRANIAL DOPPLER IN MIGRAINE

Changes in the diameter of intracranial arteries might have a major ro le in the pathophysiology of migraine. Though several studies have fou nd alterations in velocity of blood flow and in cerebral vasomotor rea ctivity of intracranial arteries in migraineurs in headache-free perio ds, as well as during migraine attacks, the results are inconclusive. To determine if intracranial hemodynamic characteristics of patients w ith migraine differ from those of controls, we measured baseline veloc ity of blood flow by transcranial Doppler in the middle cerebral arter ies in headache-free periods in 51 migraine patients and in 101 age-ma tched controls. Cerebrovascular reactivity was measured after intraven ous administration of acetazolamide in 12 migrainous patients and in 1 9 controls. Baseline mean velocity was significantly higher in the mig raine group (70 versus 65 and 72 versus 65 cm/s with P = 0.02 and P = 0.0007 on the left and right sides, respectively). The difference stay ed significant during acetazolamide stimulation, but the course of res ponse did not differ between controls and migraineurs. Despite statist ical significance, absolute differences were small. Therefore, middle cerebral artery velocity measurements and the acetazolamide test are n ot useful for the diagnosis of migraine in the interictal period.