Migraines – Headache

The vascular system and its influence under stimuli of the autonomic or neurovegetative nervous system play an extremely important role, not only in Neurootology, but also in the origin of severe headache or migraine.

Every modification in capillary diameter produces nourishment disorders at cell level modifying its functions. Changes in capillary diameter could be the result of vessels dilation phenomena as it takes place in hypotensions, or of vessels spasms as it should be the case of blood hypertension.

From our Data Bank analysis, it becomes evident that 57,89% of neurootological patients present haemodynamical alterations in capillaries, 29,57% corresponding to hypertension phenomena or spasticity and 28,32% to hypotension phenomena or capillary dilations.

On top of this, 42% of patients consult on severe headaches, migraine or cephaleas, associate or not to other neurootological symptoms.

On those patients showing migraine or severe headaches the study on cerebral haemodynamics is strictly applied by means of USD-Transcranial and of the USD-Extracranial,thus issuing a diagnosis on the sort and features of cerebral vascular disorders.

As per the results obtained through studies on cerebral haemodynamics, it has been found that our patients suffer from:

%
Headache or Migraine
 
53.20%
Vasospastic form
 
29.80%
Vasodilatic form
 
9.09%
Combined
 
7.70%
Without haemodynamic variations

On patients below 40 years old, there is an equal distribution between vasospastic and vasodilatic forms, whilst on patients over 60 years old vasospastic forms prevail in 80% of the studies.

Supra D
Supra I

61 years old patient suffering from migraine prevailing on the left. Extracranial USD of right supratrochlear artery is within regular range, the left supratrochlear artery shows an acceleration of the flow with an increase of the stenosis index and turbidity. Typical example of vasomotorial migraine towards spastic form.

Supra D
Supra I

58 years old patient with diffuse headache, cognitive disorders with several months of evolution. Transcranial USD of middle cerebral arteries denotes a severe hypoflow of the middle left cerebral artery.

reposo
estimulacion auditiva

22 years old patient suffering from vasomotorial migraine towards dilatatory form. Through EEG mapping normal responses are observed in resting and wakefulness state. Under auditory stimulation, a slow down in the design is observed with an increase in Delta waves. Typical process of dispolarization which could be objectified in migraine manifestations.

Migraine treatment should be:

  1. Symptomatological
    Directed to counteract sharp pain symptoms.

  2. Etiopathogenetic
    Directed to the type of vascular or neuronal affection.

  3. Prophylactic
    Which also makes it possible to establish a preventive therapy in order to prevent future irreversible cerebral damages, as it happens in cerebrovascular diseases.