Pathology of Migraines

Migraines usually occur at the reduction of blood flow and occurs during cerebral hyperperfusion in the headache phase. Migraine is viewed as a disorder that influences cerebral hemodynamics. It can be said that blood flow changes do not always correlate with the symptoms seen in a migraine attack. Multiple factors influences a migraine: chemical, metabolic, neurogenic and myogenic. https://scite.ai/reports/10.1097/00002508-199009000-00011

Vascular pathology is often associated with migraines, because endothelial dysfunction may be an early marker for migraines.

Larrosa-Campo D, Ramón-Carbajo C, Álvarez-Escudero R, et al. [Arterial pathology in migraine: endothelial dysfunction and structural changes in the brain and systemic vasculature]. Revista de Neurologia. 2015 Oct;61(7):313-322. PMID: 26411276.

Current treatment and mechanism of action

• Ergot alkaloids: If it is an acute migraine= ergotamide, if migraine prophylaxis=methysergideInduces vasoconstriction which is long-lasting.
• Autocoids:migraine prophylaxis=flunarizine.