Association of sustained oxyhemoglobin desaturation and onset of cluster headache attacks

Headache
L Kudrow, D B Kudrow

Abstract

Ten episodic cluster headache patients in their active cluster period, ten patients in remission and five control subjects were monitored for minute to minute changes in oxygen saturation (SaO2) and pulse rate before and after nitroglycerin (NTG) administration. A transient but significant decrease in SaO2 and increase in pulse rate of 25 minutes duration occurred following NTG in all groups. These changes may reflect physiologic hemodynamic effects of NTG as a smooth muscle relaxant. Subsequently, SaO2 levels and pulse rate recovered to baseline values in remission and control groups. In contrast, SaO2 values in the active cluster group decreased further and after an extended period culminated in cluster headache attacks in 10/10 patients. Three major changes, therefore, distinguished active cluster patients from remission and control groups. First, the magnitude of oxygen desaturation increased after the physiological effects of NTG ceased. Second, oxygen desaturation was sustained for an additional 9 to 30 minutes duration. Third, the hypoxemic state culminated in attacks in all cases. Our findings suggest that the active cluster period may be characterized by an impaired mechanism to autoregulate, and thus compensate, for h...Continue Reading

Citations

Mar 17, 2001·Current Pain and Headache Reports·D W Dodick, D J Capobianco
Feb 26, 2004·Current Pain and Headache Reports·Dale M Carter
Mar 11, 2009·Current Pain and Headache Reports·Steven B Graff-Radford, Antonia Teruel
Apr 18, 2000·Sleep Medicine· Nath Zallek S, R D Chervin
Jun 16, 2005·Cephalalgia : an International Journal of Headache·M E NobreP M F Filho
Sep 26, 2009·The Journal of Headache and Pain·Edoardo MampresoGiorgio Zanchin
Jul 10, 2007·Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics·Ramesh Balasubramaniam, Gary D Klasser
Jun 3, 2004·Primary Care·Frederick G Freitag
May 6, 2016·Cephalalgia : an International Journal of Headache·Josefine BritzeMessoud Ashina
Nov 15, 2015·Cephalalgia : an International Journal of Headache·Jerome C Oude NijhuisPeter J Koehler
Feb 13, 2001·Cephalalgia : an International Journal of Headache·D W DodickS D Silberstein
Jun 1, 1992·Cephalalgia : an International Journal of Headache·L Kudrow
Jul 6, 2000·Neurology·R D ChervinK M Hedger

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