FEATURES OF HEMODYNAMICS IN HEAD MAGISTRAL AND CEREBRAL ARTERIES IN THE PATIENTS WITH MIGRAINE.

OBJECTIVE: The aim of the study was to Doppler sonography study of the structural and functional state of head magistral arteries (HMA) and cerebral arteries in the patients with various forms of migraine. PATIENTS AND METHODS: Materials and methods: We conducted the clinical Doppler examination of 124 young patients (18-45 years old), including 55 men and 69 women in the conditions of the clinical base of the Kharkiv Medical Academy of Postgraduate Education in 2017-2019. The criteria for involvement of patients in the study were: migraine without aura (group 1 - 63 patients), migraine with aura (group 2 - 61 patients) The control group consisted of 45 patients of the corresponding gender and age. The condition of HMA and cerebral arteries was studied using the ultrasound device. RESULTS: Results: The presence of extravasal compressions of vertebral arteries (VA) is typical for the patients with migraine, as well as for some cases of the hypoplasia of the VA in the group of the patients with migraine with aura. In the patients with migraine with aura, there was a decrease in the velocity values in the extracranial VA segments. The velocity values in the external carotid arteries (ECA) were slightly reduced in both groups. The most significant were the changes in the hemodynamics in the middle cerebral arteries (MCA), which were manifested by the pattern of the excessive perfusion in the patients of the migraine without aura and the pattern of the hampered perfusion in the MCA in the patients of the migraine with aura. CONCLUSION: Conclusions: 1. In the patients with migraine with aura, a decrease in the velocity values in the extracranial segments of the VA was observed, in some cases combined with the hypoplasia of the vertebral artery, the hampered perfusion in middle cerebral arteries. 2. The excessive perfusion in middle cerebral arteries is the most critical hemodynamic pattern in the patients with migraine without aura. 3. The extravasal compression of vertebral arteries, combined with the hyperperfusion in posterior cerebral arteries, is a typical hemodynamic pattern both in the group of the patients with migraine with aura, and in the group of the patients with migraine without aura.

FEATURES OF CEREBROVASCULAR REACTIVITY IN PATIENTS OF YOUNG AGE WITH MIGRAINE.

OBJECTIVE: The aim of the study was to Doppler sonography study of cerebrovascular reactivity in young patients with migraine and comparison of autoregulation patterns between groups of migraine patients with aura and migraine without aura. PATIENTS AND METHODS: Materials and methods: We conducted the clinical Doppler examination of 124 young patients (18-45 years old), including 55 men and 69 women in the conditions of the clinical base of the Kharkiv Medical Academy of Postgraduate Education in 2017-2019. The criteria for involvement of patients in the study were: migraine without aura (group 1-63 patients), migraine with aura (group 2-61 patients) The control group consisted of 45 patients of the corresponding gender and age. The indicators of CVR were studied using the ultrasound device. RESULTS: Results: A hyperreactive response to tests with CO2 and photoreactivity were more pronounced in the patients with migraine without aura. The patients with migraine with aura showed hyperreactivity in the test with O2, which was an indicator of the tendency to hyperconstriction. The hyperreactivity in the functional nitroglycerin test and the carotid compression test shows the state of the myogenic mechanism of changes in vascular tone. Insignificant hyperreactivity to orthostatic load detected in both groups shows the interest of the neurogenic regulatory link. CONCLUSION: Conclusions: 1. The most important hemodynamic patterns in the patients with migraine are excessive perfusion with migraine without aura and difficult perfusion with migraine with aura. 2. For the patients with migraine without aura, a characteristic criterion for autoregulation is the pattern of hyperreactivity hypercapnic load and photostimulation. 3. The most important difference in the autoregulatory response in the patients with migraine with aura compared with migraine without aura is the hyperresponse to hyperventilation load, compression carotid and nitroglycerin tests.