TCD-ERGOMETER-TEST IN PATIENTS WITH TENSI ON-TYPE HEADACHE

In the etiopathology of tension type headache,vascular and autonomic d isorders are discussed. Fifteen patients with chronic tension type hea dache according to the criteria of the IHS were investigated using the TCD-ergometer-test - a method used to evaluate the myogenic mechanism of cerebrovascular autoregulation - and the results were compared wit h the findings in fifteen healthy control subjects. The patients' Mean Flow Velocity (TAV(mean)) and Resistance Index (RI) at rest and after exercise were significantly decreased (p <0,05). During exercise they normalized. The patients' endtidal pCO(2) at rest and during exercise was significantly lower than the corresponding values of the control group (p <0,05). Regarding blood pressure elevation and heart rate inc rease during exercise both groups did not differ significantly (p >0,0 5). These findings suggest that patients with tension type headache ha ve a diminished vascular tone in the cerebral vessels at rest which is normalised during exercise. The reduced endtidal pCO(2) is considered as a physiological response to increase vascular tone via metabolic m echanism of cerebrovascular autoregulation. In conclusion it is sugges ted that therapeutic procedures which activate sympathetic autonomic n ervous function to train cerebral vessels should be more carefully con sidered.