Cutaneous blood flow in vascular headaches of the migraine type

Abstract

The tissue clearance method of Na-24 was employed for the study of frontotemporal skin blood flow in patients with vascular headaches of the migraine type. Asymptomatic patients exhibit blood flows equal to those of normal control subjects. During headache, however, the flows are increased above those of asymptomatic subjects and the blood flow on the side of the headache is greater than the contralateral side. Some increased flow of the contralateral side is also present, suggesting extension of the process across the mid-line. The observed increase in frontotemporal skin blood flow is not part of a systemic increase in flow, since there is no associated increase in forearm flow. Norepinephrine and ergotamine tartrate effectively relieve migraine headache while reducing local tissue blood flow. Since both drugs act essentially by constricting arteries and arterioles, it is concluded that the increased tissue blood flow during migraine is intimately and perhaps etiologically related to the pain. Bradykinin may increase local skin flow, but this alone does not lead to vascular headache. Methysergide maleate has no definite effect on cutaneous blood flow.