International Medical Journal, Vol. 22., Iss. 3, 2016, P. 93−96.
INVESTIGATION OF CEREBRAL HEMODYNAMICS AND CEREBROVASCULAR REACTIVITY IN PATIENTS WITH DIFFERENT TYPES OF HEADACHE
Kharkiv Medical Academy of Postgraduate Education, Ukraine
At present, headache is the most frequent complaint appearing at various conditions. Migraine (M), tension−type headache (TTH) and vertebrocogenic headache (VH) are best−known and most common neurological diseases occurring in the adult population. Cerebral hemodynamics and CVR were investigated using transcranial Doppler sonography (TDS) in patients with different types of the headache. The diagnosis was made according to the criteria of the International Classification of HD, 2nd revision (2003). The parameters of the linear blood flow velocity (BFV) in the cerebral arteries were investigated using TDS. The state of cerebrovascular reactivity was assessed using the following functional loads: hypercapnic load (coefficient of reactivity CrCO2), hyperventilation load (CrO2), orthostatic load (CrOL), antiorthostatic load (CrAOL), functional nitroglycerin test (CrFNT), functional metabolic test (CrFMT). Hemodynamic disturbances in the studied persons often manifested by increased BFV in the medial cerebral arteries and posterior cerebral arteries, and asymmetry of BFV in the MCA and VA. The CrFNT parameters CrCO2 and CrO2 were significantly increased in patients with migraine. The patients with TTH demonstrated hyperreactivity at FMT, hyperreactivity to CO2−load and hyporeactivity to O2−load. The patients with VH revealed hyperreactivity at FMT and hyporeactivity to O2−load. All clinical groups showed hyperreactivity at orthostatic load. These figures demonstrate hyperreactivity to FNT, CO2 and O2−load, probably associated with a shift in the humoral metabolic regulation. Cerebral hemodynamics in patients with headache is characterized by angiodystonic phenomena.
Key words: transcranial Doppler sonography, cerebral hemodynamics, cerebrovascular reactivity, migraine, tension−type headache, cervicogenic headache.