OBJECTIVE: We aimed to assess whether migraine is associated with changes in the distribution of the venous drainage through primary and secondary pathways by using phase-contrast magnetic resonance imaging (MRI). METHODS: We examined 26 patients (37.3 ± 13.9 years) with recurring migraine headaches and 26 age- and gender-matched controls with no neurologic disease (37.3 ± 13.7 years) on a 3 Tesla MR scanner. A 2D time-of-flight MR-venography of the upper neck region was performed to visualize the venous vasculature. Cine-phase contrast scans with high-velocity encoding were employed to quantify arterial inflow and flow in the primary venous channels (right and left jugular veins), whereas scans with low-velocity encoding were employed to quantify flow in the secondary venous channels (epidural, vertebral, and deep cervical veins). RESULTS: Patients with migraine showed (i) a higher prevalence of dense secondary extracranial venous networks (15 vs. 2, P = 0.00002) and (ii) a significantly larger percentage of venous outflow through secondary channels (10.5% vs. 5.5%; of total cerebral blood flow, P = 0.02). This mainly included drainage through epidural, vertebral, and deep cervical veins. CONCLUSION: Migraine patients showed a significantly larger percentage of venous outflow through secondary channels. The mechanism of this alteration remains to be elucidated. Potential mechanisms include repeated release of vasoactive substances or growth factors.
OBJECTIVE: We aimed to assess whether migraine is associated with changes in the distribution of the venous drainage through primary and secondary pathways by using phase-contrast magnetic resonance imaging (MRI). METHODS: We examined 26 patients (37.3 ± 13.9 years) with recurring migraine headaches and 26 age- and gender-matched controls with no neurologic disease (37.3 ± 13.7 years) on a 3 Tesla MR scanner. A 2D time-of-flight MR-venography of the upper neck region was performed to visualize the venous vasculature. Cine-phase contrast scans with high-velocity encoding were employed to quantify arterial inflow and flow in the primary venous channels (right and left jugular veins), whereas scans with low-velocity encoding were employed to quantify flow in the secondary venous channels (epidural, vertebral, and deep cervical veins). RESULTS:Patients with migraine showed (i) a higher prevalence of dense secondary extracranial venous networks (15 vs. 2, P = 0.00002) and (ii) a significantly larger percentage of venous outflow through secondary channels (10.5% vs. 5.5%; of total cerebral blood flow, P = 0.02). This mainly included drainage through epidural, vertebral, and deep cervical veins. CONCLUSION:Migrainepatients showed a significantly larger percentage of venous outflow through secondary channels. The mechanism of this alteration remains to be elucidated. Potential mechanisms include repeated release of vasoactive substances or growth factors.
Authors: Noam Alperin; James R Loftus; Carlos J Oliu; Ahmet M Bagci; Sang H Lee; Birgit Ertl-Wagner; Raymond Sekula; Terry Lichtor; Barth A Green Journal: Neurosurgery Date: 2015-07 Impact factor: 4.654
Authors: Sonu Bhaskar; Andrew Bivard; Mark Parsons; Michael Nilsson; John R Attia; Peter Stanwell; Christopher Levi Journal: J Cereb Blood Flow Metab Date: 2016-07-20 Impact factor: 6.200
Authors: H Charles Woodfield; D Gordon Hasick; Werner J Becker; Marianne S Rose; James N Scott Journal: Biomed Res Int Date: 2015-12-10 Impact factor: 3.411
Authors: Andreas Pomschar; Inga Koerte; Sang Lee; Ruediger P Laubender; Andreas Straube; Florian Heinen; Birgit Ertl-Wagner; Noam Alperin Journal: PLoS One Date: 2013-02-06 Impact factor: 3.240