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pineal gland, parts of the pituitary gland, the blood flow pattern is followed by a much longer lasting, ypothalamus and other tissues. So some of our mos spreading, oligaemic (diminished) blood flow pattern. important brain organs, like the pituitary and The SD wave can be triggered by electrical, mechanical ypothalamus, have diminished BBB protection. — or toxic factors. Migraine cessation has also been Corticotropin-releasing hormone (CRH), released by the _ attained by the elimination of certain foods. ypothalamus during stress, has been found to cause Recent research has found a delayed BBB permeability BBB permeability. increase and subsequent cortical oedema from a single Researchers have found that BBB cells alone regulated episode of an SD wave, and that repetitive SD waves he amount of glucose entering the brain, and that the cause BBB permeability beginning within two hours of BBB created more glucose transporter molecules within onset.“ Another study has found that "chronic cerebral itself in response to hyperinsulin-induced hypoperfusion induces BBB damage with subsequent ypoglycaemia in rats.” So perhaps we should say tha morphological changes of the vascular structure in the he blood-brain barrier itself has a brain. This corpus callosum".” (The corpus callosum lies between compensating effect was noted in rats that recovered on _ the two brain hemispheres and is involved in dyslexia heir own after two days of hypoglycaemia. and other problems.) The associated leakage into the brain of macromolecules, such as proteases and Migraines, Strokes and the Hole in the Heart immuno-globulins, may contribute to the formation of igraine sufferers often also suffer from depression, |white-matter lesions (visible on MRI) which are anxiety/panic and_ sleep associated with decreased problems. All these may entai cognition in the elderly. increased permeability of the But what can cause chronic BBB. Migraine without aura is One out of about every cerebral hypoperfusion? Hidden called common migraine. three people has a hole or heart conditions are known to Migraine with aura is called do this. One in particular is classic migraine. The aura stage tunnel between the two involved in migraines, strokes consists of visual disturbances: upper chambers of the and other problems. This is the flashing lights, zigzagging lines, . patent foramen ovale (pronounced rainbow areas, vertigo, loss o heart that did not seal "pay-tent foray-men oh-val-ee"), part of the visual field, pins and mi or PFO. It is an atrial septal needles on one side of the face, properly In infancy. defect. One out of about every three and numbness. people has a hole or tunnel between the Classic migraine has three two upper chambers of the heart that phases: the aura phase, the headache phase and the _ did not seal properly in infancy.% This is partially based on post-headache phase. The aura phase lasts about a half- — analysis of a 1984 Mayo Clinic autopsy study of 965 hour, and often has a preceding premonition phase. The people, which excluded obviously diseased hearts. The onset of the painful headache phase usually ends the _ study revealed a 27.3 per cent prevalence for all ages. aura phase. The throbbing or pounding headache pain For people who died in their first three decades of life, may start out in one area and spread to a much larger he prevalence was 34.3 per cent. As obviously diseased area, and can last for hours up to a day. The headache earts were excluded, 27.3 per cent is likely a significant phase can be accompanied by severe sensitivity to light, | underestimate for the entire population. Enlightened smells, sounds and touch. The post-headache phase can __ researchers now cite a 35 per cent PFO prevalence.” include chills, sweats, diuresis, polyuria and shakes. The PFO allows for poorly oxygenated blood to go to Common migraine may have precursor events of he brain and the rest of the body. Recent research has moodiness, fatigue or mental lapses. The headache _ proven the role of the PFO in causing migraines (more so phase may be similar to the classic migraine headache _ if there is aura), ischaemic strokes and transient phase. One can also have the purely optic migraine of — ischaemic attacks (TIAs) which usually include the mind feeling sick with aura symptoms, including temporary going blank. Strokes and TIAs occur, in part, because the PFO partial loss of the visual field, but without getting the causes clots or micro-clots to form. The PFO may be causative headache. The aura phase has been suspected of being __ of, or linked to, exercise intolerance, asthma, pulmonary due to vasoconstriction, and the headache phase due to __ hypertension and cardiac degeneration. It gets larger vasodilation. Recently, the aura phase has been said to —_ and more problematic with age. coincide with a cortical spreading depression (SD) wave. When closure of the PFO was attained, via catheter This is a depolarisation (reversal or reduction of the implantation of a small closure device, migraines were electrical potential of cell membranes) wave moving at —serendipitously found to cease in many sufferers, about three millimetres per minute in the cerebral including divers. It can prevent new strokes from cortex. Cerebral blood flow is altered during this SD — occurring. Such devices currently all contain nickel, wave. A brief, spreading, hypaeremic (above normal) | which can be problematic for allergic or porphyric pineal gland, parts of the pituitary gland, the ypothalamus and other tissues. So some of our mos important brain organs, like the pituitary and ypothalamus, have diminished BBB protection. Corticotropin-releasing hormone (CRH), released by the ypothalamus during stress, has been found to cause BBB permeability. Researchers have found that BBB cells alone regulated he amount of glucose entering the brain, and that the BBB created more glucose transporter molecules within itself in response to hyperinsulin-induced ypoglycaemia in rats.” So perhaps we should say tha he blood-brain barrier itself has a brain. This compensating effect was noted in rats that recovered on heir own after two days of hypoglycaemia. three people has a hole or tunnel between the two upper chambers of the heart that did not seal APRIL - MAY 2011 NEXUS ¢ 39 One out of about every properly in infancy. www.nexusmagazine.com