Neurological Sciences

, Volume 29, Supplement 1, pp 44–46 | Cite as

Migraine with and without aura share the same pathogenic mechanisms

  • R. Allan Purdy
Headache Controversies


Migraine with aura and without aura share the same clinical features with respect to the headache, and differ nosologically in the presence or absence of aura. The mechanisms of aura generation are now becoming clearer, based on imaging studies, and a common migraine pathophysiology for all subtypes of migraine headaches now seems reasonable, as it would seem implausible that all of these neurological events have different pathogenic mechanisms. Both major subtypes of migraine clearly represent a perturbation of normal physiology and employ normal anatomic pathways to generate the aura and headache, similar to aura and a seizure. So what is the mechanism of migraine aura? Do migraine without aura patients have clinically silent aura? Migraine is after all defined as a clinical disorder and is the prototypic primary headache and thus its uniform pathogenesis must underlie all that we know about migraine clinically. This presentation will take the resolve that the migraine with and without aura share the same pathogenic mechanisms.


Migraine Aura Mechanisms Pathophysiology 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Headache Classification Committee of The International Headache Society (2004) The International Classification of Headache Disorders (second edition). Cephalalgia 24[Suppl 1]:1–160Google Scholar
  2. 2.
    Russell MB, Olesen J (1996) A nosographic analysis of the migraine aura in a general population. Brain 119:355–361PubMedCrossRefGoogle Scholar
  3. 3.
    Gowers WR (1888) A manual of diseases of the nervous system. P. Blakiston, Son & Co, PhiladelphiaGoogle Scholar
  4. 4.
    Olesen J, Larsen B, Lauritzen M (1981) Focal hyperemia followed by spreading oligemia and impaired activation of rCBF in classic migraine. Ann Neurol 9:344–352PubMedCrossRefGoogle Scholar
  5. 5.
    Cutrer FM, Sorensen AG, Weisskoff RM et al (1998) Perfusion-weighted imaging defects during spontaneous migrainous aura. Ann Neurol 43:25–31PubMedCrossRefGoogle Scholar
  6. 6.
    Sanchez del Rio M, Bakker D, Wu O et al (1999) Perfusion weighted imaging during migraine: spontaneous visual aura and headache. Cephalalgia 19:701–707PubMedCrossRefGoogle Scholar
  7. 7.
    Hadjikhani N, Sanchez del Rio M, Wu O et al (2001) Mechanisms of migraine aura revealed by functional MRI in human visual cortex. Proc Natl Acad Sci U S A 98:4687–4692PubMedCrossRefGoogle Scholar
  8. 8.
    Lauritzen M (1994) Pathophysiology of the migraine aura. The spreading depression theory. Brain 117:199–210PubMedCrossRefGoogle Scholar
  9. 9.
    Olesen J, Friberg L, Skyhoj-Olsen T et al (1990) Timing and topography of cerebral blood flow, aura, and headache during migraine attacks. Ann Neurol 28:791–798PubMedCrossRefGoogle Scholar
  10. 10.
    Wolff HG (1963) Headache and other head pain, 3rd Edn. Oxford University Press, New YorkGoogle Scholar
  11. 11.
    Leao AAP (1944) Spreading depression of activity in cerebral cortex. J Neurophysiol 7:359–390Google Scholar
  12. 12.
    Leao AAP (1947) Further observations on the spreading depression of activity in the cerebral cortex. J Neurophysiol 10:409–414Google Scholar
  13. 13.
    Marshall WH (1959) Spreading cortical depression of Leao. Physiol Rev 39:239–288PubMedGoogle Scholar
  14. 14.
    Lauritzen M (2001) Cortical spreading depression in migraine. Cephalalgia 21:757–760PubMedCrossRefGoogle Scholar
  15. 15.
    Olesen J (1991) Cerebral and extracranial circulatory disturbances in migraine: pathophysiological implications. Cerebrovasc Brain Metab Rev 3:1–28PubMedGoogle Scholar
  16. 16.
    Cohen AS, Goadsby PJ (2004) Functional neuroimaging of primary headache disorders. Curr Neurol Neurosci Rep 4:105–110PubMedCrossRefGoogle Scholar
  17. 17.
    Woods RP, Iacoboni M, Mazziotta JC (1994) Bilateral spreading cerebral hypoperfusion during spontaneous migraine headache. N Engl J Med 331:1689–1692PubMedCrossRefGoogle Scholar
  18. 18.
    Géraud G, Denuelle M, Fabre N et al (2005) Positron emission studies in migraine. Rev Neurol (Paris) 161:666–670Google Scholar

Copyright information

© Springer-Verlag Italia 2008

Authors and Affiliations

  1. 1.Department of MedicineDalhousie UniversityHalifaxCanada

Personalised recommendations