Document Detail


The effect of intravenous verapamil on cerebral hemodynamics in a migraine patient with hemiplegia.
MedLine Citation:
PMID:  10669185     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To describe the use of intravenous verapamil in a migraine patient with hemiplegia to reverse the symptomatology and hemodynamics of the middle cerebral artery as determined by transcranial Doppler. CASE SUMMARY: A 31-year-old white woman was admitted with an acute exacerbation of migraine with hemiplegia. A transcranial Doppler showed an increased flow velocity through the middle cerebral artery consistent with a migrainous process. The patient was treated with verapamil 5 mg iv and the hemiplegia gradually resolved. A transcranial Doppler indicated that the flow velocity through the middle cerebral artery was decreased after verapamil administration, indicating reversal of the vasospasm. DISCUSSION: Transcranial Doppler has not been previously used to determine the effect of intravenous verapamil on the migrainous process. Intravenous verapamil reversed the altered hemodynamics of the middle cerebral artery as determined by transcranial Doppler. This finding correlated with the gradual resolution of hemiplegia. Whether both subjective and objective findings in this patient can be attributed to the reversal of the cerebral artery hemodynamics is not known. CONCLUSIONS: Intravenous verapamil appears to reverse the vasospasm that may be associated with a migrainous process. Whether this effect is solely responsible for clinical improvement is not known. Verapamil may be a consideration for the treatment of intractable migraine, especially when there is evidence of spasm of the major cerebral arteries.
Authors:
T M Ng; A Kohli; S C Fagan; A E Mohamed; G Geiszt
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  The Annals of pharmacotherapy     Volume:  34     ISSN:  1060-0280     ISO Abbreviation:  Ann Pharmacother     Publication Date:  2000 Jan 
Date Detail:
Created Date:  2000-02-24     Completed Date:  2000-02-24     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9203131     Medline TA:  Ann Pharmacother     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  39-43     Citation Subset:  IM    
Affiliation:
Department of Pharmacy Practice, Wayne State University, Detroit, MI, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Calcium Channel Blockers / administration & dosage,  therapeutic use*
Cerebrovascular Circulation / drug effects*
Female
Hemiplegia / complications,  drug therapy*
Hemodynamics / drug effects
Humans
Injections, Intravenous
Middle Cerebral Artery / drug effects,  physiology
Migraine Disorders / complications,  drug therapy*
Time Factors
Ultrasonography, Doppler, Transcranial
Verapamil / administration & dosage,  therapeutic use*
Chemical
Reg. No./Substance:
0/Calcium Channel Blockers; 52-53-9/Verapamil

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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