Abstract | UNLABELLED: Despite recent research advances, the origin of nociception in migraine headaches remains unclear and continues to be a topic of intense examination. Experiments using animal models of dural neurogenic plasma extravasation ( DNPE) as an index of meningeal inflammation provided the basis for the meningeal inflammation hypothesis of migraine pain. OBJECTIVE: We explore the possibility that DNPE can be detected in humans during a migraine attack. METHODS:
DNPE single photon emission computerized tomography (SPECT) with an intravenous injection of technetium-99m (Tc-99m) human serum albumin (HSA) has been used in a 46-year-old migraine symptomatic patient who met the International Headache Society criteria for episodic migraine. The patient was injected with 10 mCi HSA and imaged by SPECT. A second (delayed) SPECT was done 3 hours later. After 3 days, following complete resolution of her migraine headache, the patient returned for the control SPECT. RESULTS: All SPECT images were compared with the patient's self-recorded pictorial description of her migraine head pain epicenter. Tc-99m HSA extravasation appeared on the same side and approximately in the same region as the epicenter of the patient's head pain. CONCLUSION: This observation suggests the occurrence of intracranial plasma extravasation during migraine attacks. Activity on SPECT scans suggests that tracer extravasation and not hyperemia is responsible for the positive finding.
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Authors | Helena Knotkova, Marco Pappagallo |
Journal | Pain medicine (Malden, Mass.)
(Pain Med)
2007 May-Jun
Vol. 8
Issue 4
Pg. 383-7
ISSN: 1526-2375 [Print] England |
PMID | 17610461
(Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
- Radiopharmaceuticals
- Technetium Tc 99m Aggregated Albumin
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Topics |
- Capillary Permeability
- Extravasation of Diagnostic and Therapeutic Materials
(diagnostic imaging)
- Female
- Humans
- Hyperacusis
(complications)
- Hyperemia
- Meninges
(pathology)
- Middle Aged
- Migraine without Aura
(complications, diagnostic imaging)
- Photophobia
(complications)
- Plasma
(physiology)
- Radiopharmaceuticals
- Technetium Tc 99m Aggregated Albumin
- Tomography, Emission-Computed, Single-Photon
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