AlexTk
02.02.2005, 00:19
Magnetic Resonance
Imaging in Migraine
Reviewed by John B. Chawluk, MD
Department of Neurology, Drexel University School of
Medicine, Philadelphia, PA
[Rev Neurol Dis. 2004; 1 (4):216-218]
2004 MedReviews, LLC
Approximately 20 years ago the term neopoznannyj shone object, *quot; ???*quot; UBO became a word from a medical slang, drawing of attention, but also having reflected the sad fact that T2-weighed magnitno-resonant display (MRI) is very sensitive in detection of a cerebral pathology, but is insufficiently specific. Soon after that, observation has been made, that the migraine is one more neurologic status, at which *quot; ?N?N?o??N??N*quot; the hyperintensive centers (WMH) are found out more often in comparison with people without a headache.
Inconsistent reports vtrechalis that suffering a migraine really have greater or big predilection to cerebral damages than control group.
Two recent researches have shown high percent or interest of disturbances M among suffering a migraine.
Cranial Magnetic Resonance Imaging Findings
in Patients With Migraine
Gozke E, Ore O, Dortcan N, et al.
Headache. 2004; 44:166-169.
The report concerning 45 patients with a migraine with or without
Auras Gozke with colleagues, has disadvantages on selection and quantity or amount of patients. Results show research, that the hyperintensive centers on T2-weighed images M are found out twice more often
At patients with a migraine with aura (40 %) in comparison with a migraine without aura (20 %) (P *lt; .05).
Also imetsja communication or connection between quantity or amount of attacks and changes on MRT though on any statistical value or meaning;importance do not inform. Average
Duration of a migraine was longer in patients with
The hyperintensive centers (149.5 months) than at patients without the centers (134.1 months), but these differences were not statistically essential.
Vascular risk factors, including presence or absence
Vasculites, have been taken into consideration though authors obviously did not allocate patients with a lipidemia or smoking.
Migraine as a Risk Factor for Subclinical
Brain Lesions
Kruit MC, van Buchem MA, Hofman PAM, et al.
JAMA. 2004; 291:427-434.
Report Kruit with partners much more correctly on design,
Also provides more detailed data concerning presence
And distribution of that authors name subclinical
Cerebral damages at a migraine. The main advantage of research that was it is spent randomizirovannyj selection of faces of age from 20 - 60 years.
In an initial stage of selection, 863 cases of a migraine
Have been identified, in 54 % of cases earlier not diagnostirovanyh the doctor as a migraine! Though it is possible or probable a little bit surprisingly, but it
Statistically it is completely compatible to results American Migraine II study where it is noted, that not diagnosed number of cases of a migraine in the United States was 52 %.
The full estimation of a social and medical demography has been executed, including an educational level, smoking, use of oral contraceptives, an index of mass of a body, arterial pressure, and a full level of a cholesterin.
The estimation of quantity or amount of attacks of a headache in month and used treatment (ergotamines and triptans) was spent on the basis of questioning.
Viewings M have been executed on 1.5 T or 1.0 T scanners
With more thin axial sections than used usually clinical reports (3 mm). Also the method was used also
FLAIR (fluid-attenuated inversion recovery imaging) possessing much greater sensitivity.
From 435 studied or investigated patients (middle age of 48.5 years), at 31
It is revealed 60 chronic cerebral infarcts in the size from 2 mm up to 21 mm. The number of infarcts in -basilar pool (PCI) was much more at women suffering a migraine (16 cases, 5.4 %) against the control (1 case, 0.7 %) (P = .02). As a whole, 33 chronic PCIs have been noticed, 1 in the bridge and 32 in a cerebellum.
The augmentation of frequency of attacks of a headache has been connected with much increased risk for PCI (P *lt; .005). Besides PCI met more often at patients a migraine with aura (8.1 %)
In comparison with faces without aura (2.2 %) (P = .03).
The risk of greater -VA and diameter of the hyperintensive centers was much more at women with a migraine in comparison with
The control (odds ratio, 2.1; 95 %; confidence interval 1.0-4.1). This risk raises or increases from frequency of attacks of a migraine (P = .008). Such dependence it has not been noticed at men, and thus there was no augmentation at them periventrikuljarnyh the hyperintensive centers in comparison with the control.
Reports Kruit and Gozke podtverzhajut opinion that the migraine, especially a migraine with aura, through mechanisms still not completely studied or investigated, conducts to the progressing cerebral damage having clinical correlation. While it is obscure first of all the reason of cerebral damages these are secondary vascular reactions at a migraine or these are vascular accompanying diseases are responsible or crucial for cerebral damages at patients with a migraine.
In support of last hypothesis speak recent reports where essential dependence between patent foramen ovale (PFO) and a migraine, with closing PFO is noticed, the leader to drama simplification of a migraine.
Thus the neurologists observing patients with a migraine should pay attention not only to rendering of the fast help at acute attacks, but also on depression of quantity or amount and intensity of attacks for prophylaxis of a chronic cerebral pathology.
References
1. Kaplan RD, Solomon GD, Diamond S, Freitag FG. The role of MRI in the eval-uation
of a migraine population. Preliminary data. Headache. 1987; 27:315-318.
2. Fazekas F, Koch M, Schmidt R, et al. The prevalence of cerebral damage
varies with migraine type: a MRI study. Headache. 1992; 32:287-291.
3. Gozke E, Ore O, Dortcan N, et al. Cranial magnetic resonance imaging find-ings
in patients with migraine. Headache. 2004; 44:166-169.
4. Kruit MC, van Buchem MA, Hofman PAM, et al. Migraine as a risk factor for
subclinical brain lesions. JAMA. 2004; 291:427-434.
5. Lipton RB, Diamond S, Reed M, et al. Migraine diagnosis and treatment:
results from the American Migraine II. Headache. 2001; 41:638-645.
6. Lipton RB, Pan J. Is migraine a progressive brain disease? (editorial.) JAMA.
2004; 291:493-494.
7. Sandor PS, Mascia A, Seidel L, et al. Subclinical cerebellar impairment in the
common types of migraine: a three-dimensional analysis of reaching move-ments.
Ann Neurol. 2001; 49:668-672.
8. Del Sette M, Angeli S, Leandri M, et al. Migraine with aura and right-to-left
shunt on transcranial Doppler: a case-control study. Cerebrovasc Dis. 1998;
8:327-330.
9. Carerj S, Narbone MC, Zito C, et al. Prevalence of atrial septal aneurysm in
patients with migraine: an echocardiographic study. Headache. 2003; 43:
725-728.
10. Schwerzman M, Wiher S, Nedeltchev K, et al. Percutaneous closure of patent
foramen ovale reduces the frequency of migraine attacks. Neurology. 2004;
62:1399-1401.
Imaging in Migraine
Reviewed by John B. Chawluk, MD
Department of Neurology, Drexel University School of
Medicine, Philadelphia, PA
[Rev Neurol Dis. 2004; 1 (4):216-218]
2004 MedReviews, LLC
Approximately 20 years ago the term neopoznannyj shone object, *quot; ???*quot; UBO became a word from a medical slang, drawing of attention, but also having reflected the sad fact that T2-weighed magnitno-resonant display (MRI) is very sensitive in detection of a cerebral pathology, but is insufficiently specific. Soon after that, observation has been made, that the migraine is one more neurologic status, at which *quot; ?N?N?o??N??N*quot; the hyperintensive centers (WMH) are found out more often in comparison with people without a headache.
Inconsistent reports vtrechalis that suffering a migraine really have greater or big predilection to cerebral damages than control group.
Two recent researches have shown high percent or interest of disturbances M among suffering a migraine.
Cranial Magnetic Resonance Imaging Findings
in Patients With Migraine
Gozke E, Ore O, Dortcan N, et al.
Headache. 2004; 44:166-169.
The report concerning 45 patients with a migraine with or without
Auras Gozke with colleagues, has disadvantages on selection and quantity or amount of patients. Results show research, that the hyperintensive centers on T2-weighed images M are found out twice more often
At patients with a migraine with aura (40 %) in comparison with a migraine without aura (20 %) (P *lt; .05).
Also imetsja communication or connection between quantity or amount of attacks and changes on MRT though on any statistical value or meaning;importance do not inform. Average
Duration of a migraine was longer in patients with
The hyperintensive centers (149.5 months) than at patients without the centers (134.1 months), but these differences were not statistically essential.
Vascular risk factors, including presence or absence
Vasculites, have been taken into consideration though authors obviously did not allocate patients with a lipidemia or smoking.
Migraine as a Risk Factor for Subclinical
Brain Lesions
Kruit MC, van Buchem MA, Hofman PAM, et al.
JAMA. 2004; 291:427-434.
Report Kruit with partners much more correctly on design,
Also provides more detailed data concerning presence
And distribution of that authors name subclinical
Cerebral damages at a migraine. The main advantage of research that was it is spent randomizirovannyj selection of faces of age from 20 - 60 years.
In an initial stage of selection, 863 cases of a migraine
Have been identified, in 54 % of cases earlier not diagnostirovanyh the doctor as a migraine! Though it is possible or probable a little bit surprisingly, but it
Statistically it is completely compatible to results American Migraine II study where it is noted, that not diagnosed number of cases of a migraine in the United States was 52 %.
The full estimation of a social and medical demography has been executed, including an educational level, smoking, use of oral contraceptives, an index of mass of a body, arterial pressure, and a full level of a cholesterin.
The estimation of quantity or amount of attacks of a headache in month and used treatment (ergotamines and triptans) was spent on the basis of questioning.
Viewings M have been executed on 1.5 T or 1.0 T scanners
With more thin axial sections than used usually clinical reports (3 mm). Also the method was used also
FLAIR (fluid-attenuated inversion recovery imaging) possessing much greater sensitivity.
From 435 studied or investigated patients (middle age of 48.5 years), at 31
It is revealed 60 chronic cerebral infarcts in the size from 2 mm up to 21 mm. The number of infarcts in -basilar pool (PCI) was much more at women suffering a migraine (16 cases, 5.4 %) against the control (1 case, 0.7 %) (P = .02). As a whole, 33 chronic PCIs have been noticed, 1 in the bridge and 32 in a cerebellum.
The augmentation of frequency of attacks of a headache has been connected with much increased risk for PCI (P *lt; .005). Besides PCI met more often at patients a migraine with aura (8.1 %)
In comparison with faces without aura (2.2 %) (P = .03).
The risk of greater -VA and diameter of the hyperintensive centers was much more at women with a migraine in comparison with
The control (odds ratio, 2.1; 95 %; confidence interval 1.0-4.1). This risk raises or increases from frequency of attacks of a migraine (P = .008). Such dependence it has not been noticed at men, and thus there was no augmentation at them periventrikuljarnyh the hyperintensive centers in comparison with the control.
Reports Kruit and Gozke podtverzhajut opinion that the migraine, especially a migraine with aura, through mechanisms still not completely studied or investigated, conducts to the progressing cerebral damage having clinical correlation. While it is obscure first of all the reason of cerebral damages these are secondary vascular reactions at a migraine or these are vascular accompanying diseases are responsible or crucial for cerebral damages at patients with a migraine.
In support of last hypothesis speak recent reports where essential dependence between patent foramen ovale (PFO) and a migraine, with closing PFO is noticed, the leader to drama simplification of a migraine.
Thus the neurologists observing patients with a migraine should pay attention not only to rendering of the fast help at acute attacks, but also on depression of quantity or amount and intensity of attacks for prophylaxis of a chronic cerebral pathology.
References
1. Kaplan RD, Solomon GD, Diamond S, Freitag FG. The role of MRI in the eval-uation
of a migraine population. Preliminary data. Headache. 1987; 27:315-318.
2. Fazekas F, Koch M, Schmidt R, et al. The prevalence of cerebral damage
varies with migraine type: a MRI study. Headache. 1992; 32:287-291.
3. Gozke E, Ore O, Dortcan N, et al. Cranial magnetic resonance imaging find-ings
in patients with migraine. Headache. 2004; 44:166-169.
4. Kruit MC, van Buchem MA, Hofman PAM, et al. Migraine as a risk factor for
subclinical brain lesions. JAMA. 2004; 291:427-434.
5. Lipton RB, Diamond S, Reed M, et al. Migraine diagnosis and treatment:
results from the American Migraine II. Headache. 2001; 41:638-645.
6. Lipton RB, Pan J. Is migraine a progressive brain disease? (editorial.) JAMA.
2004; 291:493-494.
7. Sandor PS, Mascia A, Seidel L, et al. Subclinical cerebellar impairment in the
common types of migraine: a three-dimensional analysis of reaching move-ments.
Ann Neurol. 2001; 49:668-672.
8. Del Sette M, Angeli S, Leandri M, et al. Migraine with aura and right-to-left
shunt on transcranial Doppler: a case-control study. Cerebrovasc Dis. 1998;
8:327-330.
9. Carerj S, Narbone MC, Zito C, et al. Prevalence of atrial septal aneurysm in
patients with migraine: an echocardiographic study. Headache. 2003; 43:
725-728.
10. Schwerzman M, Wiher S, Nedeltchev K, et al. Percutaneous closure of patent
foramen ovale reduces the frequency of migraine attacks. Neurology. 2004;
62:1399-1401.