A much abbreviated version of this paper will be published in the proceedings of the 7th Migraine Trust International Symposium.
Arterial Stenosis in Migraine: Spasm or Arteriopathy?†
Article first published online: 20 MAY 2005
Headache: The Journal of Head and Face Pain
Volume 30, Issue 2, pages 52–61, January 1990
How to Cite
Solomon, S., Lipton, R. B. and Harris, P. Y. (1990), Arterial Stenosis in Migraine: Spasm or Arteriopathy?. Headache: The Journal of Head and Face Pain, 30: 52–61. doi: 10.1111/j.1526-4610.1990.hed3002052.x
- Issue published online: 20 MAY 2005
- Article first published online: 20 MAY 2005
- Accepted for Publication: September 8, 1989
- Cited By
Segmental arterial narrowing has rarely been angiographically demonstrated in patients with migraine. One new case is reported and 12 previous cases are reviewed. Though often referred to as vasospasm, arteriographic stenosis may result from edema of the vessel wall, arterial dissection, the effects of puerperium or arteritis.
A biphasic course of spasm, similar to the pattern noted with subarachnoid hemorrhage, has been recorded in some migraineurs. The current neurogenic and biochemical concepts of “spasm” developed for subarachnoid hemorrhage are reviewed.
Arterial narrowing may be important in several phenomena associated with migraine. It may account for migrainous cerebral infarction or hemorrhage. Vasoconstriction has also been invoked to explain the aura and other features of migraine. But the site of stenosis does not always correlate with the headache or focal neurologic features in location or timing. The angiographic changes are probably an epiphenomena rather than a primary mechanism of migraine. These changes may result from altered sympathetic neuronal activity; factors supporting that concept are reviewed.