偏头痛的病理生理学一、血管机能障碍与偏头痛十九世纪以来,人们注意到偏头痛发作期间病人血管舒缩机能异常。Graham等曾论述过在偏头痛性头痛期间病人颞浅动脉搏动幅度增大,他们认为偏头痛发作前先兆的神经系症状与颈动脉床血管收缩有关,而血管随后的被动舒张导致了头痛。显然,酒石酸麦角胺能中止偏头痛发作是因为它有收缩血管的性质。多年后,Heyck强调大脑颈动脉动静脉吻合(AVAs)的作用。AVAs的开放能使来自毛细血管床的血液分流,造成脑血氧过 Pathophysiology of migraine 1. Vascular dysfunction and migraine Since the nineteenth century, people have noticed that patients with vasomotor dysfunction during migraine attacks. Graham et al. Have discussed patients with increased temporal arterial pulse amplitude during migraine headache. They suggest that the neurological symptoms of migraine attacks precede the vasoconstriction of the carotid artery bed, and subsequent passive relaxation of the blood vessels results in headache. Obviously, ergotamine tartrate can stop the onset of migraine because of its vasoconstrictive properties. Years later, Heyck emphasized the role of cerebral arteriovenous anastomoses (AVAs) in the brain. The opening of AVAs can divert blood from the capillary bed, resulting in cerebral oxygenation