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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Forms of sleep apnea syndrome: Interrupted breathing and hypoventilation during sleep lead to sleep disorders and to cardiovascular sequelae. In the common obstructive sleep apnea syndrome (OSAS) apneas are related to intermittent obstruction of the upper airways. In the rarer central sleep apnea syndrome certain cardiovascular or central nervous system disorders lead to disturbed regulation of respiration connected with periodic breathing. Signs indicating OSAS: Loud, cyclic snoring, interrupted by cessation of breathing during sleep observed by relatives and excessive daytime to diurnal sleepiness indicate OSAS. Furthermore alteration of personality, headache in the morning, non-refreshing sleep and nocturnal choking sensations may indicate OSAS. When is evaluation necessary? Patients with complaints possibly induced by OSAS should be further evaluated since nocturnal application of continuous positive airway pressure (CPAP) by means of a nose mask and other treatment forms often lead to significant improvement of OSAS. In addition patients with untreated OSAS have an increased risk for car accidents and premature death as consequence of cardiovascular diseases. The type and extent of a supposed respiratory disorder is evaluated by means of a sleep study.
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PMID:[Indications in sleep-apnea syndrome. When and why is further assessment meaningful?]. 919 Jun 46

Interictal cerebrovascular reactivity and blood flow velocities were tested in 23 patients with migraine without aura and 10 age- and sex-matched healthy controls by using the breath holding index (BHI). The mean systolic, diastolic and mean velocities and pulsatility indices were not different in the controls and patients. The BHI was found to be significantly greater (P=0011) in the patients (1.64 +/- 0.33) compared with the controls (1.26 +/- 0.37), showing an exaggerated reactivity to hypercapnia in migraineurs. Reactivity to pCO2 theoretically depends on pre-existing arteriolar tone and thereby on baseline velocity. Our finding of similar blood flow velocities in controls and patients suggests that the underlying cause for this high reactivity may not be an increased vasotonus but an increased sensitivity to changes in blood CO2 levels.
Cephalalgia 2002 May
PMID:Exaggerated interictal cerebrovascular reactivity but normal blood flow velocities in migraine without aura. 1210 91

Migraine is hypothesized to be a neurovascular coupling disorder where the cerebral vascular reactivity is malfunctioning and measuring hemodynamic changes during migraine without causing more disturbance has always been a challenge. Functional near infrared spectroscopy system (fNIRS) is being proposed as an inexpensive, rapid, safe and accurate alternative to fMRI, transcranial doppler sonography (TCD). We have developed NIROXCOPE 201, a novel device for fNIRS which offers 16 source-detector pairs distributed on a probe that is placed on the forehead. Measuring hemodynamic changes during migraine without causing more disturbance has always been a challenge. Using NIROXCOPE 201, we have attempted to investigate the cerebrovascular reactivity of migraine patients to a breath hold task which produces a metabolic perturbation. Six normals and six migraine patients performed four consecutive breath holding task. We calculated the peak and latencies of the initial dip and recovery phases for [Hb], [HbO(2)], [tHb], and [OXY] signals. [Hb], [tHb], and [OXY] ID and R amplitudes of normals are approximately a magnitude higher than migraine patients (P<0.01), while latencies showed no significant differences. Data suggests an altered neurovascular coupling in frontal cortex of migraine patients interictally. The application of NIROXCOPE 201 to patients suffering from other primary headache disorders will reveal diagnostic as well as therapeutic implications of the presented study.
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PMID:Cerebrovascular dynamics in patients with migraine: near-infrared spectroscopy study. 1651 81

Migraine is a neurovascular disorder characterized by autonomic nervous system dysfunction and severe headache attacks. Studies have shown that changes in the intracranial vessels during migraine have an important role in the pathophysiology. Many studies have been conducted on the increased risk of stroke in patients with migraine, but insufficient data are available on the mechanism underlying the increase. This study aimed to evaluate basal cerebral blood flow velocity and vasomotor reactivity in patients with chronic migraine. We evaluated 38 patients with chronic migraine. Three of them were excluded because they had auras and four of them were excluded because of their use of medication that can affect cerebral blood flow velocity and breath holding index (beta or calcium channel blockers). Our study population consisted of 31 patients with chronic migraine without aura and 29 age- and gender-matched healthy individuals who were not taking any medication. The mean blood flow velocity and breath holding index were measured on both sides from the middle cerebral artery and posterior cerebral artery, with temporal window insonation. The breath holding index for middle cerebral artery and posterior cerebral artery was significantly lower in the migraine group compared to that of the control group (p < 0.05).The vasomotor reactivity indicates the dilatation potential of a vessel, and it is closely related to autoregulation. According to our results, the vasodilator response of cerebral arterioles to hypercapnia was lower in patients with chronic migraine. These findings showed the existence of impairments in the harmonic cerebral hemodynamic mechanisms in patients with chronic migraine. This finding also supports the existing idea of an increased risk of stroke in patients with chronic migraine due to impaired vasomotor reactivity.
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PMID:Reduced breath holding index in patients with chronic migraine. 2530 11