Headache
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We report a case of reversible cerebral vasoconstriction, possibly secondary to the use of indomethacin to relieve pain during a migraine with aura attack. Non-steroidal anti-inflammatory drugs are not reported among substances precipitating secondary forms of reversible cerebral vasoconstriction. A transcranial Doppler sonography study, performed during the phase with headache and the other neurological deficits, suggested the presence of distal cerebral vasospasm, which normalized when all symptoms regressed completely (<24 hours). We speculated that indomethacin might represent the trigger factor of these particular phenomena, by acting either directly on distal cerebral vessels, or under certain predisposing conditions, such as migraine with aura attacks.
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The objectives of this study were to develop a preclinical rodent model that produces migraine-like behaviors based on International Headache Society diagnostic criteria, to determine whether sex differences are present, and to determine whether expression of calcitonin gene-related peptide (CGRP) and the genes encoding its receptor in trigeminal ganglion or medulla correlates with those behaviors. ⋯ This study demonstrates significant changes in locomotor activity and facial allodynia associated with application of IS to the dura as well as significant sex differences, demonstrating that International Headache Society diagnostic criteria can be used to design a rodent behavioral model of migraine. In addition, there were prominent baseline sex differences in expression of CGRP and its receptor in both the trigeminal ganglion and medulla, but the majority of changes in expression of CGRP and its receptor were present in both the IS and PBS treated rats. This suggests that the CGRP pathway responds to changes in intracranial pressure or meningeal stretch, while migraine-like behaviors occur after meningeal inflammation.