Unique CT Perfusion Imaging in a Case of HaNDL: New Insight into Pathophysiology of Acute Attacks (P4.114)

Conclusions: The pattern of global left hemispheric hypoperfusion seen in this case supports previous hypotheses of secondary oligemia induced by a hemispheric wave of cortical spreading depression (CSD). However, the right ACA territory hypoperfusion represents a phenomenon never previously reported in this field. We speculate that the secondary vasomotor changes induced by CSD in the left hemisphere, spread to the right hemisphere via the anomalous vascular supply. Such a mechanism of direct vascular propagation through vessel gap junctions has been described in animal studies. This unique case provides a valuable contribution towards understanding HaNDL pathophysiology and in doing so may also yield broader implications regarding neurophysiological principles of CSD.Disclosure: Dr. Burke has nothing to disclose. Dr. Lamb has nothing to disclose. Dr. Hohol has received personal compensation for activities with Bayer HealthCare, Biogen Idec, EMD Serono, Genzyme, Novartis, Roche and Teva Neuroscience as speaker, consultant, and/or advisory board member. Dr. Lay has received personal compensation for activities with Tribute as an advisory board participant.
Source: Neurology - Category: Neurology Authors: Tags: Headache: Imaging and Other Source Type: research