Altered cerebrovenous drainage in patients with migraine as assessed by phase-contrast magnetic resonance imaging

Inga K. Koerte, Christoph J. Schankin, Stefanie Immler, Sang Lee, Ruediger P. Laubender, Christina Grosse, Lara Eftimov, Astrid Milde-Busch, Maximilian Reiser, Andreas Straube, Florian Heinen, Noam Alperin, Birgit Ertl-Wagner

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Objective: We aimed to assess whether migraine is associated with changes in the distribution of the venous drainage through primary and secondary pathways by using phase-contrast magnetic resonance imaging (MRI). Methods: We examined 26 patients (37.3 ± 13.9 years) with recurring migraine headaches and 26 age-and gender-matched controls with no neurologic disease (37.3 ± 13.7 years) on a 3 Tesla MR scanner. A 2D time-of-flight MR-venography of the upper neck region was performed to visualize the venous vasculature. Cine-phase contrast scans with highvelocity encoding were employed to quantify arterial inflow and flow in the primary venous channels (right and left jugular veins), whereas scans with low-velocity encoding were employed to quantify flow in the secondary venous channels (epidural, vertebral, and deep cervical veins). Results: Patients with migraine showed (i) a higher prevalence of dense secondary extracranial venous networks (15 vs. 2, P = 0.00002) and (ii) a significantly larger percentage of venous outflow through secondary channels (10.5% vs. 5.5%; of total cerebral blood flow, P = 0.02). This mainly included drainage through epidural, vertebral, and deep cervical veins. Conclusion: Migraine patients showed a significantly larger percentage of venous outflow through secondary channels. The mechanism of this alteration remains to be elucidated. Potential mechanisms include repeated release of vasoactive substances or growth factors.

Original languageEnglish
Pages (from-to)434-440
Number of pages7
JournalInvestigative Radiology
Volume46
Issue number7
DOIs
StatePublished - Jul 1 2011

Fingerprint

Migraine Disorders
Drainage
Magnetic Resonance Imaging
Veins
Cerebrovascular Circulation
Phlebography
Jugular Veins
Nervous System Diseases
Intercellular Signaling Peptides and Proteins
Neck

Keywords

  • Migraine
  • Phase-contrast imaging
  • Secondary venous channels
  • Total cerebral blood flow
  • Venous outflow

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Koerte, I. K., Schankin, C. J., Immler, S., Lee, S., Laubender, R. P., Grosse, C., ... Ertl-Wagner, B. (2011). Altered cerebrovenous drainage in patients with migraine as assessed by phase-contrast magnetic resonance imaging. Investigative Radiology, 46(7), 434-440. https://doi.org/10.1097/RLI.0b013e318210ecf5

Altered cerebrovenous drainage in patients with migraine as assessed by phase-contrast magnetic resonance imaging. / Koerte, Inga K.; Schankin, Christoph J.; Immler, Stefanie; Lee, Sang; Laubender, Ruediger P.; Grosse, Christina; Eftimov, Lara; Milde-Busch, Astrid; Reiser, Maximilian; Straube, Andreas; Heinen, Florian; Alperin, Noam; Ertl-Wagner, Birgit.

In: Investigative Radiology, Vol. 46, No. 7, 01.07.2011, p. 434-440.

Research output: Contribution to journalArticle

Koerte, IK, Schankin, CJ, Immler, S, Lee, S, Laubender, RP, Grosse, C, Eftimov, L, Milde-Busch, A, Reiser, M, Straube, A, Heinen, F, Alperin, N & Ertl-Wagner, B 2011, 'Altered cerebrovenous drainage in patients with migraine as assessed by phase-contrast magnetic resonance imaging' Investigative Radiology, vol. 46, no. 7, pp. 434-440. https://doi.org/10.1097/RLI.0b013e318210ecf5
Koerte, Inga K. ; Schankin, Christoph J. ; Immler, Stefanie ; Lee, Sang ; Laubender, Ruediger P. ; Grosse, Christina ; Eftimov, Lara ; Milde-Busch, Astrid ; Reiser, Maximilian ; Straube, Andreas ; Heinen, Florian ; Alperin, Noam ; Ertl-Wagner, Birgit. / Altered cerebrovenous drainage in patients with migraine as assessed by phase-contrast magnetic resonance imaging. In: Investigative Radiology. 2011 ; Vol. 46, No. 7. pp. 434-440.
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abstract = "Objective: We aimed to assess whether migraine is associated with changes in the distribution of the venous drainage through primary and secondary pathways by using phase-contrast magnetic resonance imaging (MRI). Methods: We examined 26 patients (37.3 ± 13.9 years) with recurring migraine headaches and 26 age-and gender-matched controls with no neurologic disease (37.3 ± 13.7 years) on a 3 Tesla MR scanner. A 2D time-of-flight MR-venography of the upper neck region was performed to visualize the venous vasculature. Cine-phase contrast scans with highvelocity encoding were employed to quantify arterial inflow and flow in the primary venous channels (right and left jugular veins), whereas scans with low-velocity encoding were employed to quantify flow in the secondary venous channels (epidural, vertebral, and deep cervical veins). Results: Patients with migraine showed (i) a higher prevalence of dense secondary extracranial venous networks (15 vs. 2, P = 0.00002) and (ii) a significantly larger percentage of venous outflow through secondary channels (10.5{\%} vs. 5.5{\%}; of total cerebral blood flow, P = 0.02). This mainly included drainage through epidural, vertebral, and deep cervical veins. Conclusion: Migraine patients showed a significantly larger percentage of venous outflow through secondary channels. The mechanism of this alteration remains to be elucidated. Potential mechanisms include repeated release of vasoactive substances or growth factors.",
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AU - Lee, Sang

AU - Laubender, Ruediger P.

AU - Grosse, Christina

AU - Eftimov, Lara

AU - Milde-Busch, Astrid

AU - Reiser, Maximilian

AU - Straube, Andreas

AU - Heinen, Florian

AU - Alperin, Noam

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N2 - Objective: We aimed to assess whether migraine is associated with changes in the distribution of the venous drainage through primary and secondary pathways by using phase-contrast magnetic resonance imaging (MRI). Methods: We examined 26 patients (37.3 ± 13.9 years) with recurring migraine headaches and 26 age-and gender-matched controls with no neurologic disease (37.3 ± 13.7 years) on a 3 Tesla MR scanner. A 2D time-of-flight MR-venography of the upper neck region was performed to visualize the venous vasculature. Cine-phase contrast scans with highvelocity encoding were employed to quantify arterial inflow and flow in the primary venous channels (right and left jugular veins), whereas scans with low-velocity encoding were employed to quantify flow in the secondary venous channels (epidural, vertebral, and deep cervical veins). Results: Patients with migraine showed (i) a higher prevalence of dense secondary extracranial venous networks (15 vs. 2, P = 0.00002) and (ii) a significantly larger percentage of venous outflow through secondary channels (10.5% vs. 5.5%; of total cerebral blood flow, P = 0.02). This mainly included drainage through epidural, vertebral, and deep cervical veins. Conclusion: Migraine patients showed a significantly larger percentage of venous outflow through secondary channels. The mechanism of this alteration remains to be elucidated. Potential mechanisms include repeated release of vasoactive substances or growth factors.

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