We do tell people before foam sclerotherapy
that they might get a migraine. Now I have only seen this in people who suffer with migraine
anyway. It is very rare. It is a known complication of foam sclerotherapy. We think it is due
to the fact that the delicate cells that line the vein – the endothelium – they are
disrupted by the foam sclerotherapy (that is what starts a healing process). And the
endothelial cells have within them a large number of so-called “vasoactive amines”.
The most familiar to the general public will be histamine. That is released during the
sclerotherapy process and that is why you get a histamine-type reaction after sclerotherapy.
But it has recently been identified that another vasoactive amine called “Endothelin” is
released and that is what triggers a migraine attack. I tell people because if you have
never had a migraine attack and you do a migraine “out of the blue”, it can be very frightening
with a blinding headache, flashing lights in front of the eyes and perhaps disturbance
of vision. I probably only see this once or twice a year, and we do a lot of foam sclerotherapy
(don’t we Pam) in this clinic. We always warn people. It only happens while the patient
is here: it tends to happen immediately after injection and it doesn’t last very long.
It doesn’t occur on the way home for example after the patient has left the clinic. If
it does happen we will keep the patient in a quiet room undisturbed and it passes off
in a few minutes. So that is another precaution we take (after foam sclerotherapy) – we
warn people about the possibility of migraine after foam sclerotherapy.