Cerebrovascular reactivity during the Valsalva maneuver in migraine, tension-type headache and medication overuse headache - PubMed (original) (raw)

. 2011 Oct-Dec;26(4):223-7.

Affiliations

Cerebrovascular reactivity during the Valsalva maneuver in migraine, tension-type headache and medication overuse headache

T M Wallasch et al. Funct Neurol. 2011 Oct-Dec.

Abstract

The aim of this study was to investigate, by means of transcranial Doppler ultrasound (TCD), cerebrovascular reactivity during the Valsalva maneuver (VM) during the headache-free interval in patients with migraine (M), migraine plus tension-type headache (M+TTH), and migraine plus medication overuse headache (M+MOH). A total of 114 patients (n=60 M, n=38 M+TTH, n=16 M+MOH) and n=60 controls were investigated; diagnoses were made according to the International Headache Society criteria. All subjects underwent TCD monitoring and, simultaneously, non-invasive assessment of arterial blood pressure and end-tidal CO2. Two indices were determined: the cerebrovascular Valsalva ratio (CVR) was calculated as the maximum end-diastolic flow velocity acceleration during the late straining phase of the VM [cm/s2] and the centroperipheral Valsalva ratio (CPVR) was defined as the quotient of CVR to the concomitant arterial blood pressure acceleration [cm/mmHg x s]. The dynamic cerebrovascular autoregulatory response to the VM, measured as CVR, was increased in patients with M and M+TTH compared to age-matched healthy subjects. By contrast, CPVR (i.e. the quotient of the cerebrovascular to the peripheral autonomic response), was increased in M patients compared to healthy subjects and all other headache conditions tested. Cerebrovascular autoregulatory response during the VM was increased in M patients compared to age-matched normal healthy subjects, indicating a disturbed autonomic control of cerebral vasoreactivity. The CPVR seems to be a sensitive parameter for distinguishing between M patients and M+TTH or M+MOH patients.

PubMed Disclaimer

Similar articles

Cited by

References

    1. Arjona A , Perula de Torres LA , Serrano-Castro PJ , Guardado-Santervas PL , Olivares J , Rubi-Callejon J . A transcranial Doppler study in interictal migraine and tension-type headache . J Clin Ultrasound . 2007 ; 35 : 372 – 375 . - PubMed
    1. Kastrup A , Thomas C , Hartmann C , Schabet M . Cerebral blood flow and CO2 reactivity in interictal migraineurs: a transcranial Doppler study . Headache . 1998 ; 38 : 608 – 613 . - PubMed
    1. Valikovics A , Oláh L , Fülesdi B , et al. Cerebrovasular reactivity measured by transcranial Doppler in migraine . Headache . 1996 ; 36 : 323 – 328 . - PubMed
    1. Thie A , Fuhlendorf A , Spitzer K , Kunze K . Transcranial Doppler evaluation of common and classic migraine. Part I. Ultrasonic features during the headache-free period . Headache . 1990 ; 30 : 201 – 208 . - PubMed
    1. Abernathy M , Donnelly G , Kay G , et al. Transcranial Doppler sonography in headache-free migraineurs . Headache . 1994 ; 34 : 198 – 203 . - PubMed

MeSH terms

Substances

LinkOut - more resources