Blood flow velocity and pulsatility index differences in patients with unilateral migraine

Objective.-To evaluate blood flow velocity and pulsatility in unilateral mi graine without aura during the headache-free period using transcranial Dopp ler (TCD) sonography. Methods.-Patients with unilateral headache were recruited during the headac he-free period. Maximum mean flow velocity (MFV) and pulsatility index (PI) were measured in the middle cerebral (MCA) and basilar arteries. Controls were headache-free individuals without cerebrovascular disease. Results.-Twenty-five patients with right-sided migraine, 25 patients with l eft-sided migraine, and 19 controls were studied. The MCA PI was higher on the right headache side versus the left headache side (0.97 +/- 0.2 versus 0.86 +/- 0.1 cm/s, P =.02) and versus controls (0.9 +/- 0.2 cm/s, NS). The basilar artery MFV was higher in patients with right-sided headache versus left-sided headache (39.5 +/- 5.6 versus 34.7 +/- 8.2 cm/s, P =.02) and ver sus controls (38.2 +/- 8 cm/s, NS). No decrease in MFV with age was observe d in patients with migraine. Conclusions.-Middle cerebral artery flow pulsatility and basilar artery vel ocity are higher in patients with right-sided migraine compared with left-s ided migraineurs, during the headache-free period. Although these parameter s were similar to controls, the differences found during the headache-free period in migraineurs may indicate vascular involvement predisposing to the unilateral headache recurrence.