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Small Blood-vessels In Migraine.

J. Blau, E. Davis
Published 1970 · Medicine

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Abstract Conjunctival, lip, tongue, and nailfold vessels have been examined micro scopically in 35 migrainous subjects between attacks The vessels were normal, but 12 out of the 35 showed intravascular red-cell aggregation (I.R.C.A.)—a sub stantially higher proportion than in controls. 11 subjects were also photographed during attacks of migraine: conjunctival arterioles, capillaries, and venules became constricted in 6 and dilated in 5. The vasomotor responses were invariably bilateral, although more distinct on the headache side. During attacks all subjects showed I.R.C.A.; and, where this feature had been present between episodes, the aggregation became more pronounced. The conjunctiva became œdematous in 3 of the 11. 7 patients were observed in more than one attack and the vascular response remained the same in the particular subject. No changes were observed in tongue vessels. Lip and nailfold vessel responses fell within the normal range of "spontaneous" vasomotor variation. The vascular responses in migraine are bilateral; the headache may be associated with conjunctival vasoconstriction or vasodilatation; œdema of the conjunctivae can occur with either vascular response; and the symptoms and the anatomical derivation of the conjunctival vessels support the view that an intracranial component contributes to the pain of a migraine headache.
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