Gamma-aminobutyric acid (GABA) and 3′, 5′-cyclic adenosine monophosphate (cyclic AMP) were measured in cerebrospinal fluid (CSF) of patients with stroke and vascular headache of migraine type. GABA was elevated in CSF of patients with recent onset of thromboembolic occlusive cerebrovascular disease (CVD) and within 48 hours of an attack of vertebrobasilar ischemia (VBI). Similarly, GABA was elevated in CSF of all patients studied during a migraine attack but not in asymptomatic migraine patients or patients with muscle contraction (tension) headache. CSF cyclic AMP was also elevated in patients with recent onset of thromboembolic occlusive CVD and in patients studied during or within 48 hours of a migraine attack.
Since biochemical abnormalities reported herein were common to occlusive CVD and migraine headache, it seems probable that they are due to ischemia associated with both conditions and possibly related to the resultant disorder of cerebral energy metabolism.