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Das Konzept der „Erweiterten Stroke-Unit“ beschreibt eine zusatzliche strukturelle Option fur bereits zertifizierte Stroke-Units mit dem Ziel, die stark akuttherapeutisch ausgerichtete Behandlung der Schlaganfallpatienten auf deutschen Stroke-Units in starkerem Mase durch fruhe Mobilisationsbehandlung und neuropsychologische Rehabilitationsmasnahmen zu erganzen. Dieses Konzept wird in vielen europaischen Landern empfohlen. Hintergrund dafur ist die auf hochstem Evidenzlevel nachgewiesene Wirksamkeit dieses kombinierten Behandlungspaketes in mehreren randomisierten Studien. Entsprechend den Forderungen der Helsingborg Deklaration soll dem Schlaganfallpatienten eine kontinuierliche Behandlungskette zur Verfugung stehen. In der Erweiterten Stroke-Unit kann die initial eingeleitete, fruhe Mobilisations- und Rehabilitationsbehandlung ohne Unterbrechung fortgefuhrt werden. Dadurch wird eine Schnittstelle zwischen der bisherigen Stroke-Unit und der Allgemeinstation beseitigt. Die nichtmonitorisierten „Enhanced-Care-Betten“ und die Monitorbetten sind deshalb in ein- und derselben raumlichen Einheit lokalisiert. Die Weiterversorgung eines akuten Schlaganfallpatienten durch dasselbe Team auf derselben Stroke-Unit bedeutet einen Qualitats- und Zeitgewinn und eine bessere Nutzung der Personalressourcen. Die dem Konzept zugrunde liegenden wissenschaftlichen Hintergrunde und seine Vorteile werden dargestellt, ebenso die strukturellen und personellen Voraussetzungen. Die fur Enhanced-Care-Betten besonders geeignete Klientel wird beschrieben und das Leistungsspektrum des Behandlungsteams definiert. Das vorliegende Konzept soll Grundlage einer optionalen Zusatzzertifizierung bereits zertifizierter Stroke-Units werden. Eine wichtige Aufgabe bestand darin, das Konzept so zu gestalten, dass es sich zwanglos in die bereits bestehende Infrastruktur der zertifizierten Regionalen oder Uberregionalen Stroke-Units einfugt. Unter okonomischen Gesichtspunkten kann eine Erweiterte Stroke-Unit voraussichtlich kostenneutral oder mit einem Plus betrieben werden.

Thirty-seven patients, aged 47 +/- 22 years, diagnosed suffering from vertebrobasilar insufficiency (VBI), underwent a hemorheological examination; 20% of these patients had no vascular risk-factor but none showed complete normal hemorheological findings. The distribution of hemorheological parameters was comparable to those in patients suffering from stroke or TIA. Abnormal were platelet-reactivity in 78%, plasma-viscosity in 57%, fibrinogen in 23%, red-blood-cell-aggregation in 13% and hematocrit in 11% of all cases. To obtain more information on how to classify common clinical symptoms i.e. headache in combination with vertigo it may be useful to introduce hemorheological parameters as platelet-reactivity, plasma-viscosity, fibrinogen, in the further laboratory examination of those patients.

ZusammenfassungDer Arzt steht oft vor dem Problem, dass er weiß, was die Leitlinien der DGN zur Sekundärprophylaxe des Schlaganfalles sagen. Nur muss der Arzt einen Patienten, den er z. B. nie in eine Studie hätte aufnehmen können, behandeln. Hierzu bedarf es eines Pragmatismus, der die Kosten für das System, aber vor allem die individuelle Situation des Patienten berücksichtigen muss. Hinzu kommt, dass Studien Fragen offen lassen. Für die Wahl des Aggregationshemmers ist die individuelle Situation des Patienten wichtig. Blutdrucksenkung bei Patienten, die zu wenig Flüssigkeit aufnehmen, muss hinterfragt werden. 24-Stunden- Blutdruckmessungen sollten zur Beurteilungsbasis werden, um nächtliche Blutdruckabfälle nicht zu übersehen. Lipidsenker sind statistisch zwar bei älteren Patienten in der Hirninfarktprophylaxe wirksam, dürften aber kaum die erste und wichtigste Maßnahme darstellen. Wichtig ist bei allen medikamentös möglichen Einzeleffekten die Machbarkeit in der Praxis, z. B. die Gesamtmenge der verordneten Medikamente im Auge zu behalten.

The number of circulating platelet aggregates was assessed using a modification of the method of Wu and Hoak. The index for the number of circulating aggregates was 1.04 +/- 0.12 for 35 healthy probands aged 35 +/- 11 years and was different from the index of 25 patients with vasomotor headache aged 37 +/- 14 years of 1.1 +/- 0.14 (P less than 0.1). The number of circulating platelet aggregates with an index of 1.38 +/- 0.24 was significantly higher (P less than 0.001) in 48 migraine patients aged 36 +/- 12 years.

If a patient presents with symptoms of a functional somatic pain syndrome in the primary care setting, it is important to confirm the diagnosis based on a thorough history and physical examination including selected diagnostic tests to exclude somatic diseases with a similar clinical presentation. Important aspects of psychosomatic medicine in the primary care setting are to discuss the diagnosis, treatment options, and prognosis of the functional psychosomatic pain syndromes with the patient in detail. Patients who present with a functional somatic pain syndrome to secondary or tertiary care centers, should be screened for additional functional pain syndromes. A psychiatric-psychosomatic evaluation might be indicated. Based on criteria of evidence-based medicine, psychotherapy and/or tricyclic antidepressants seem to be the most promising treatment approaches for the functional somatic pain syndromes.

This paper reviews the effects of piracetam on platelet function and the evidence for its antiplatelet effect which is mediated mainly by inhibition of platelet aggregation. Piracetam also possesses antithrombotic activity in vivo. It has been shown to normalize platelet aggregation in patients with increased platelet aggregability in various disorders including acute stroke, transient cerebral ischemic attacks and diabetes mellitus. This, together with clinical improvement, has also been shown in patients with Raynaud's phenomenon. The results of recent studies are presented in which piracetam showed similar efficacy to aspirin in the secondary prophylaxis of ischemic stroke.

The etiology of spontaneous cervical artery dissection (sCAD) is largely unknown.1,2 Approximately 15% of patients with sCAD develop multiple sCAD either simultaneously or in short succession.3 Therefore, we hypothesized that patients with sCAD are generally susceptible to dissection and that this predisposition manifests itself in the arterial wall. Previously, we demonstrated signs of a generalized arteriopathy in superficial temporal artery (STA) biopsies of patients with sCAD but not of controls.4 In this study we investigated STA and skin biopsies of two pairs of identical twins in whom one twin of each pair had had a sCAD. ### Case reports. Twin 1.1 was 56 years old at the time of the dissection. He experienced severe dizziness, nausea, and vomiting preceding admission. He presented with left sided Horner syndrome only. MRI showed no brain infarct but a long dissection reaching from close to the bifurcation of the left internal carotid artery to the base of the skull. The skin and STA biopsies were performed 9 months after the dissection. Twin 1.2 is the healthy brother of 1.1. Ultrasound examination showed no dissection. Twin 2.1 was 49 years old at the time of the dissection. He experienced right-sided facial pain during the night preceding admission. The following morning he noticed a left-sided facial weakness and clumsiness of his left …

A modified platelet function test was assessed as a routine method in 71 normal subjects and 96 patients. In patients with cerebral infarction (33) and those with transitory ischaemic attacks (30) definite changes in platelet function were demonstrated. In patients with cerebrovascular insufficiency (33) there was significantly increased platelet aggregation, but in only 46% of these patients were the values over 3 standard deviations above the mean of the control group (71).

The migraine prophylactic effect of 10 mmol magnesium twice-daily has been evaluated in a multicentre, prospective, randomized, double-blind, placebo-controlled study. Patients with two to six migraine attacks per month without aura, and history of migraine of at least 2 years, were included. A 4-week baseline period without medication was followed by 12 weeks of treatment with magnesium or placebo. The primary efficacy end-point was a reduction of at least 50% in intensity or duration of migraine attacks in hours at the end of the 12 weeks of treatment compared to baseline. With a calculated total sample size of 150 patients, an interim analysis was planned after completing treatment of at least 60 patients, which in fact was performed with 69 patients (64F, 5M), aged 18–64 years. Of these, 35 had received magnesium and 34 placebo. The number of responders was 1 in each group (28.6% under magnesium and 29.4% under placebo). As determined in the study protocol, this was a major reason to discontinue the trial. With regard to the number of migraine days or migraine attacks there was no benefit with magnesium compared to placebo. There were no centre-specific differences, and the final assessments of treatment efficacy by the doctor and patient were largely equivocal. With respect to tolerability and safety, 45.7% of patients in the magnesium group reported primarily mild adverse events like soft stool and diarrhoea in contrast to 23.5% in the placebo group.

The concept of a "comprehensive stroke unit" (in German: Erweiterte Stroke-Unit) is an additional structural option for those stroke units already certified in Germany. Its aim is to complement the semi-intensive management of stroke unit patients in Germany by early mobilisation and neuropsychological rehab procedures. This concept is recommended in many European countries as well. It is based on the proof of efficacy of the combined treatment package in several randomised controlled trials. According to the Helsingborg Declaration, every stroke patient in Europe should have access to a chain of care best provided by a comprehensive stroke unit. Both early mobilisation and rehabilitation treatment can be integrated and continued without creating an interface between the acute stroke unit and the general neurological or medical ward. The monitoring beds of the acute stroke unit and the non-monitoring "enhanced care" beds are located within the same geographical area of the hospital and are run as a comprehensive stroke care entity. Continuous management of the acute stroke patients by the same team on the same unit means an increase in quality of care, better usage of staff resources and an additional gain in time. The scientific background of the advantages of a comprehensive stroke unit is described as are the structural and staff requirements. The clientel particularly benefiting from treatment on wards with enhanced care beds is described, and the spectrum of treatment services is defined. This concept will be used as the basis for an add-on qualification of already certified German stroke units. An important step was to fit the requirements of the comprehensive stroke unit to the already existing facilities and their infrastructures. From an economic point of view, the comprehensive stroke unit is expected to be cost-effective, either balanced or even positive.

The platelet levels of serotonin and the amino acids aspartic acid, glutamine, glutamic acid and gamma-aminobutyric acid were measured in 18 drug-free autistic (DSM-III criteria) and 14 age-matched healthy children. Serotonin was significantly increased while the amino acids aspartic acid, glutamine, glutamic acid and gamma-aminobutyric acid were significantly decreased in comparison with the controls. It is suggested that the decline of the amino acids in platelets from autistic children represents a biochemical marker related to infantile autism.

Chronic headache is an independent clinical picture. Headaches are to be interpreted as a warning sign from the body until this is excluded through differential diagnostics. The clarification and the initial treatment should be carried out by a neurologist to ensure sufficient diagnostic certainty.

The life time prevalence of episodic tension headache ranges between 13-66%, of chronic tension headache between 1-3%. In most studies a slight preponderance of women was found. Approximately 20% of persons afflicted by tension headache seek for medical help. The costs of tension headache are mainly indirect ones due to lost work days. Increased pain sensitivity of the pericranial muscles, psychosocial stress and psychiatric disorders are discussed as main pathophysiological mechanisms. Taking into consideration the uncertainty of the entity "tension headache" tricyclic antidepressants and psychotherapy (biofeedback, stress management therapy, autogenic training) are effective. The superiority of a multicomponent therapy with tricyclic antidepressants and stress management therapy over pharmaceutical and psychotherapeutic treatment or placebo alone was demonstrated in one study.

If a patient presents with symptoms of a functional somatic pain syndrome in the primary care setting, it is important to confirm the diagnosis based on a thorough history and physical examination including selected diagnostic tests to exclude somatic diseases with a similar clinical presentation. Important aspects of psychosomatic medicine in the primary care setting are to discuss the diagnosis, treatment options, and prognosis of the functional psychosomatic pain syndromes with the patient in detail. Patients who present with a functional somatic pain syndrome to secondary or tertiary care centers, should be screened for additional functional pain syndromes. A psychiatric-psychosomatic evaluation might be indicated. Based on criteria of evidence-based medicine, psychotherapy and/or tricyclic antidepressants seem to be the most promising treatment approaches for the functional somatic pain syndromes.

In den meisten Fallen lasst sich eine Kopfschmerzdiagnose nur aus der Anamnese und dem klinischen Befund — nicht aber aus technischen Untersuchungen wie dem MRT ableiten. Besonders bei den chronischen Kopfschmerzen, die mehr als 95% aller Kopfschmerzfalle in der Praxis ausmachen, ist die Bildgebung typischerweise unauffallig normal. Probleme in der Kopfschmerztherapie entstehen meist durch die Annahme einer nicht zutreffenden Kopfschmerzdiagnose. Die Diagnose ist der Beginn der Therapie (Blau 1991).

A total of 670 patients were screened for distal symmetric HIV-associated polyneuropathy during CDC stages 1-3 and its correlation to immunological deterioration.Clinical examinations of 670 patients admitted to the neurological outpatient clinic at the Department of Neurology, University of Munster. Neurophysiological investigations were performed on the sural and peroneal nerve for detection of axonal and myelin lesion.Clinical examination proved progressive clinical signs and symptoms indicating distal symmetric polyneuropathy from CDC 1 (32%) to CDC 3 (55%). At least one neurophysiological result was impaired in CDC 1 in 25% and in CDC 3 in 45%. Significant correlation between neurophysiological changes and CDC4(+)-cells and beta-microglobuline were detected for stage CDC 3 C.Results show stage related prevalence of distal symmetric polyneuropathy already in early stages. In late stages of HIV-infection prevalence of distal symmetric polyneuropathy seems to be directly correlated to immunodeficiency syndrome. The pathogenesis of distal symmetric polyneuropathy during HIV-infection is up to now incompletely understood, but results indicate a clear dependency between progressive immunological dysfunction and neuropathy. High active antiretroviral therapy in patients suffering from distal symmetric polyneuropathy is a main topic of future studies.

Eine relativ grose Anzahl von Kopfschmerzpatienten (in spezialisierten Praxen und Kliniken etwa 5 – 10% aller Kopfschmerzpatienten) entwickelt unter zu haufiger Einnahme von Schmerz- und/oder Migranemitteln einen sogenannten medikamenteninduzierten Kopfschmerz. Es handelt sich dabei meist um einen dumpf-druckenden Dauerkopfschmerz. Einzig sinnvolle Therapie ist die Durchfuhrung einer Entgiftung, die nach ca. 10 – 14 Tagen abgeschlossen ist. Diese kann sowohl ambulant als auch stationar in spezialisierten Praxen und Kliniken durchgefuhrt werden. Zur Vermeidung eines medikamenteninduzierten Kopfschmerzes sollten Kopfschmerzpatienten hochstens an 10 Tagen/Monat und an hochstens 3 Tagen hintereinander Kopfschmerz- und/oder Migranemittel einnehmen. Insgesamt sollte der Pravention und Therapie des medikamenteninduzierten Kopfschmerzes in der arztlichen Praxis grosere Aufmerksamkeit geschenkt werden.

This paper reviews the effects of piracetam on platelet function and the evidence for its antiplatelet effect which is mediated mainly by inhibition of platelet aggregation. Piracetam also possesses antithrombotic activity in vivo. It has been shown to normalize platelet aggregation in patients with increased platelet aggregability in various disorders including acute stroke, transient cerebral ischemic attacks and diabetes mellitus. This, together with clinical improvement, has also been shown in patients with Raynaud's phenomenon. The results of recent studies are presented in which piracetam showed similar efficacy to aspirin in the secondary prophylaxis of ischemic stroke.

To investigate progression of peripheral and central sensory tract lesion and its correlation to immunological deterioration.Clinical and neurophysiological investigation (evoked potentials of the median and tibial nerve) and immunological parameters (CD4-cells, beta 2-microglobuline) were followed up in 160 patients (24 females, 136 males, HIV infection for 2.7 +/- 2.3 years, mv +/- 1 sd) up to four times over approximately 3 years regardless of disease stage and evidence of neurological symptoms. Recordings were done using needle electrodes over the Th12 and C7 spinous process and from the scalp (10/20 system) in the conventional manner. Statistical analysis was performed intraindividually and in comparison to normal laboratory values (n = 96).All parameters deteriorated during the follow-up period. Statistical analysis showed significant differences between probands and patients for evoked potentials, but also a significant deterioration for evoked potentials after three years at the end of the follow-up study. A significant correlation between progressive impairment of evoked potentials and laboratory data was found.HIV infection induces a progressive lesion of the ascending sensory tracts. The results indicate a peripheral neuropathy as well as a progressive lesion of the ascending central sensory tracts. Pathogenesis of polyneuropathy and of central sensory tract lesion is up to now conjectural. Laboratory investigations indicate a clear-cut correlation between immunological alterations induced by HIV infection and its neurologic manifestation on ascending sensory tracts.

According to literature, repeated nerve conduction velocity measurement may yield differences of up to 10 m/s in the same subject without any need to regard these differences as pathological. In order to get more details about the reproducibility of different nerve conduction velocity parameters, 59 healthy test subjects and 47 patients suffering from diabetic polyneuropathy were investigated. In the sural nerve latency prolongation after paired stimulation, conduction velocity and amplitude of nerve action potential were determined, in the peroneal nerve conduction velocity, distal latency, amplitude of nerve action potential after distal stimulation and F-wave. All investigations were performed using surface electrodes. Measurements were repeated within one day by the same investigator using exactly the same methods. No statistically significant differences between both investigations in test subjects and patients were found. Statistically, results for patients differed significantly from healthy test subjects. Six patients showed discrepancies between both measurements in the individual estimation normal/abnormal in comparison to laboratory norm values. In conclusion, these results demonstrate that strict adherence to technical and methodological parameters-including the same investigator-results in a higher improvement of reproducibility of nerve conduction velocity measurement. Multiple factors are operating in time but strict adherence to technical, methodological, physiological and biological parameters minimises changed results of neurophysiological measurements and improves reproducibility.

Ein ischamischer Insult ist definiert durch eine akute fokale Durchblutungsstorung des Gehirns, die sich in der Regel durch ein akut auftretendes umschriebenes neurologisches Defizit, welches fluchtig oder dauerhaft sein kann, bemerkbar macht. Ein ischamischer Infarkt ist Ausdruck einer bleibenden strukturellen ischamischen Hirnschadigung.

Comparison of bisoprolol, a beta-1 selective beta blocker with no intrinsic sympathomimetic activity (ISA) and metoprolol, which numerous studies have shown to be an effective migraine prophylactic.Multicentric, cross-over study.125 patients suffering at least from 3 attacks of classic or common migraine a month for at least two years.Bisoprolol 5 mg given once a day, or metoprolol 50 mg given twice a day, for two periods of 12 weeks.125 patients were admitted to the 4-week run-in phase. A comparison of the main target: frequency of migraine attacks was thus carried out in 78 patients (f. = 63, m. = 15). Both substances reduced the average frequency of migraine per 28-day period by about 50%. There was no statistically significant difference between the two beta-blockers (p greater than 0.05).The results of the study show that 5 mg of bisoprolol and 100 mg of metoprolol a day have comparable efficacy for migraine prophylaxis, and show comparable tolerability.

Die Veranderung der Thrombozytenaggregation unter nur geringstem korperlichen Stres scheint ein prinzipielles Problem der in-vitro-Aggregationsmessung zu sein [14]. Im Gegensatz zu Aggregationsverfahren ist die Plattchenreaktivitat intraindividuell wesentlich besser reproduzierbar und relativ stabil [8]. Dennoch finden sich bei Patienten mit zerebralen Ischamien erhohte Werte fur die Plattchenreaktivitat [6]. Bei diesen Patienten konnte auserdem auffallig haufig eine pathologische Erhohung der Plasmakatecholaminspiegel beobachtet werden [2]. Untersuchungen von JACOBI [11], LANDE et al. [9] und LEVINE et al. [10] lassen immerhin einen Zusammenhang zwischen Streshormonkonzentrationen und Plattchenfunktion vermuten. Neben psychischem Stres geht physischer Stres ebenfalls mit einer vermehrten Freisetzung von Katecholaminen einher.

The result of nerve conduction velocity measuring depends upon all components of the measurement system. Earlier investigations showed that the nerve conduction velocity of the sural nerve depends also on technical attributes of recording electrodes. It was the objective of our study to investigate correlations between different recording electrodes and neurophysiological norm values as nerve conduction velocity and latency prolongation after paired stimulation of the sural nerve. Our investigations were carried out in twenty healthy volunteers aged 39 +/- 14 years. Stimulation of the sural nerve was performed at the lateral malleolus using always surface electrodes of the same type. Recording of nerve action potentials was done in each proband by four different types of electrodes. Surface electrodes consisted of tin, stainless steal and sintered silver/silver chloride, needle electrodes of stainless steel. The nerve conduction velocity using silver/silver chloride was 53.6 +/- 4.3 m/sec, using tin electrodes 53.1 +/- 3.9 m/s, using stainless steel 51.4 +/- 3.0 m/s and using needle electrodes 48,7 +/- 2.7 m/s. The Wilcoxon-test confirmed the differences of nerve conduction velocity between needle and silver/silver chloride and tin electrodes yielding p less than 0.05. Latency prolongation after paired stimulation of the sural nerve was independent from electrodes. In conclusion, our results indicate that electrodes take part in the system of standardization. Changing of recording or stimulation electrodes provoke the necessity of new standardization of norm values in clinical neurophysiology.

At a "constant" temperature of 37 degrees C, we measured the influence of the position of the temperature measurement sensor and the infrared heating element on the nervous conduction velocity (NCV) and the delay in latency after paired stimulation (LPSS) of the sural nerve. Temperature differences of up to 6.2 degrees C resulted from alteration of four cm in position of the temperature measurement sensor and the infrared heating element. NCV in the test subjects changed from 54.2 + -4.5 to 57.8 + -4.0 m/sec and the LPSS from 4.0 + -2.2% to 2.0 + -1.0%. The patients showed an increase of NCV from 54.1 + -5.0 to 56.8 + -5.7 m/sec and a decrease of LPSS from 9.9 + -5.7% to 6.5 + -3.9%. Our investigation shows that even the position of the temperature measurement sensor and the infrared heating element form a very appreciable component of the standardization method and decide on normal values. The consistent implementation of these results for routine purposes restricts the range of error of neurophysiological measurements, as well as improving the reproducibility and relevance of borderline findings.

Allgemein wird vermutet, das der Genus von Nikotin ein Risikofaktor fur vaskulare arteriosklerotisch mitverursachte Erkrankungen ist. Dieses gilt auch fur zerebrovaskulare Erkrankungen [4]. Ein weiterer in das Arteriosklerosegeschehen [12, 13] wie auch in den akuten Gefasverschlus eingebundener Faktor scheint die Einwirkung von Thrombozyten zu sein [2, 7]. Hinweise, das Rauchen direkt die Thrombozytenfunktion beeinflust, geben die Untersuchungen von Levine [8] und McVerry [11].

It was the objective of our study to find a simple and reliable method for the electroneurographic examination of the sural nerve of patients suffering from polyneuropathy. As a first step, the normal values of persons not affected by this disease were taken by orthodromic technique and surface electrodes. The results were as follows: nerve conduction velocity: 59,44 m/s ± 5,05; amplitude of the nerve action potential: 6,58 μV ± 3,05; duration of the amplitude: 2,08 ms ± 2,7; prolongation of latency after double stimulation: 3,37 % ± 0,77. Then potentials were stimulated by surface- and needle electrodes on the patients affected by polyneuropathy and recorded. Comparing the results gained by the different methods, we found that they correlated in a highly significant way, which means that all the methods are equally applicable. The stimulation and recording by surface electrodes, however, has apart from its reliability the additional advantage of being a simple, quick, and gentle method of examination. There is little objection to applying it repeatedly to the same patient. Further information about polyneuropathy can be obtained by the examination of the relative refractory period. Ziel dieser Arbeit war es, eine einfache und zuverlassige Methode zur Bestimmung der N. suralis-Neurographie bei Patienten mit einer Polyneuropathie zu finden. Es wurden zunachst in orthodromer Ableittechnik mit Oberflachenelektroden Normwerte bezuglich der Nervenleitgeschwindigkeit, der Amplitude und Dauer des Nervenaktionspotentials und der Latenzverlangerung nach Doppelreiz erstellt. Bei den Patienten wurden sowohl Oberflachen- als auch Nadelelektroden verwandt und die Techniken miteinander verglichen. Dabei zeigte sich, das die Ergebnisse in der weitaus uberwiegenden Anzahl miteinander ubereinstimmten. Somit sind die hier angewandten Methoden einander gleichwertig. Die Technik mit nur Oberflachenelektroden erfullt daruber hinaus die oben gestellte Forderung einer einfachen, schnellen und sicher zu handhabenden Routinesuchmethode, die gegenuber den Patienten schonend ist.

It has been assumed that increased release of serotonin from platelets may represent a pathogenetic factor in migraine attacks [2]. It was observed that the aggrega-bility of platelets is increased in migraine patients [5, 8], compared with patients with stroke or TIA [17], and that acetylsalicylic acid (ASA) reduces the number of migraine attacks [1, 9, 14, 15]. In addition, it has been supposed that increased aggregation of platelets is involved in migraine [11].