The Prevalence of Cerebral Damage Varies With Migraine Type: A MRI Study

Fazekas, Franz; Koch, Michael; Schmidt, Reinhold; Offenbacher, H.; Payer, F.; Freidl, Wolfgang; Lechner, H.

doi:10.1111/j.1526-4610.1992.hed3206287.x

Cited by 109 publications

(85 citation statements)

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“…Two studies examined the influence of migraine-related variables (i.e., age, migraine subtype, attack frequency, disease duration) and did not find any association with the frequency of WMAs. 7,12 Of the population-based studies (table 2), the Cerebral Abnormalities in Migraine, an Epidemiological Risk Analysis 1 (CAMERA-1) study was the first. 10 The authors investigated the prevalence of WMAs in 295 migraineurs and 140 age-and sex-matched controls, who were randomly selected from the Genetic Epidemiology of Migraine study.…”

Section: Resultsmentioning

confidence: 99%

“…These imaging procedures often reveal white matter abnormalities (WMAs) and not uncommonly reveal infarct-like lesions (ILLs), which may be a source of concern for both neurologists and patients. 6 Emerging data report that migraineurs are at increased risk for clinically silent brain lesions such as WMAs, [7][8][9][10][11][12][13][14] ILLs, 10,[13][14][15][16] and volumetric changes in gray and white matter (GM, WM) regions, [17][18][19][20][21][22][23][24] detected on MRI. The pathogenesis and clinical significance of these abnormalities is unclear.…”

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Migraine and structural changes in the brain

et al. 2013

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Objective: To evaluate the association between migraine without aura (MO) and migraine with aura (MA) and 3 types of structural brain abnormalities detected by MRI: white matter abnormalities (WMAs), infarct-like lesions (ILLs), and volumetric changes in gray and white matter (GM, WM) regions.Methods: PubMed as well as the reference lists of identified studies and reviews were used to identify potentially eligible studies through January 2013. Candidate studies were reviewed and eligible studies were abstracted. Pooled odds ratios (OR) and 95% confidence intervals (CI) were calculated for WMAs and ILLs.Results: Six population-based and 13 clinic-based studies were identified. The studies suggested that structural brain changes, including WMAs, silent ILLs, and volumetric changes in GM and WM regions, were more common in migraineurs than in control groups. The results were strongest for MA. The meta-analysis of WMAs showed an association for MA (OR 1.68; 95% CI 1.07-2.65; p 5 0.03) but not for MO (OR 1.34; 95% CI 0.96-1.87; p 5 0.08). The association of ILLs was greater for MA (OR 1.44; 95% CI 1.02-2.03; p 5 0.04) than for MO, but no association was found for MA (p 5 0.52) and MO (p 5 0.08) compared to controls. Conclusion:These data suggest that migraine may be a risk factor for structural changes in the brain. Additional longitudinal studies are needed to determine the differential influence of migraine without and with aura, to better characterize the effects of attack frequency, and to assess longitudinal changes in brain structure and function. Neurology â 2013;81:1260-1268 GLOSSARY ACC 5 anterior cingulate cortex; CAMERA 5 Cerebral Abnormalities in Migraine, an Epidemiological Risk Analysis; CI 5 confidence interval; DTI 5 diffusion tensor imaging; GM 5 gray matter; ICHD 5 International Classification of Headache Disorders; IHL 5 infratentorial hyperintense lesion; ILL 5 infarct-like lesion; MA 5 migraine with aura; MO 5 migraine without aura; OR 5 odds ratio; PAG 5 periaqueductal gray; VBM 5 voxel-based morphometry; WM 5 white matter; WMA 5 white matter abnormality.

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Section: Resultsmentioning

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Migraine and structural changes in the brain

et al. 2013

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“…In patients with migraine, MRI usually reveals focal areas of hyperintense signals on both proton density and T2-weighted spin-echo sequences. 20,21 There is one recent report of gadolinium contrast enhancement of the third cranial nerve in the T1-weighted image in a patient with ophthalmoplegic migraine, in which similar pathophysiological aspects have been discussed. 22 This case lends further support to the concept of primary parenchymal hyperperfusion while meningeal vessels are dilated in the course of a classic migraine attack, and illustrates that patients with migraine must be thoroughly questioned for seizure symptomatology and vice versa.…”

Section: We Found Few Reports Of Transient Mri Changes Associated Witmentioning

confidence: 99%

Meningeal Hyperperfusion Visualized by MRI in a Patient With Visual Hallucinations and Migraine

Lindner¹,

Reiners²,

Toyka³

1996

Headache

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A 41-year-old patient with a history of migraine but with no history of seizures had intermittent prolonged and variable complex visual hallucinations and illusions lasting 9 days, accompanied by unilateral headache. Electroencephalography during these visual symptoms revealed occipital epileptic discharges. Distinction between focal migrainous attacks and ictal phenomena was difficult. Magnetic resonance imaging showed a lesion in the right visual cortex probably related to low perfusion and hyperemia of meningeal vessels, representing the rarely described transient MRI changes associated with migraine. Continued treatment with antiepileptic drugs and calcium-channel blocking agents completely resolved the headache and visual symptoms, while minor EEG changes persisted. After discontinuation of treatment, a second attack occurred with a similar and reversible pattern on EEG.Key words: migraine, occipital lobe seizures, hallucinations, meningeal MRI alterations Abbreviation: VHIs visual hallucinations and illusions (Headache 1996;36:53-57) Focal migraine is often accompanied by visual symptoms such as scotomas or bizarre images, 1 or even with seizures and epileptic paroxysmal activity on EEG. 2 On the other hand, partial epilepsies inducing occipital lobe seizure disorders are frequently associated with headaches. 2 In the late 19th century, visual hallucinations and illusions (VHIs) as ictal phenomena were recognized for the first time. Later Hughlings Jackson (1931) observed that psychic phenomena may be manifestations of an epileptic discharge (cited by Sowa and Pituck 3 ). Cummings 1 emphasized the stereotypical pattern of VHIs in the individual patient. In contrast, Sowa and Pituck 3 reported on a patient with different VHIs as an ictal manifestation.Distinction between focal migrainous attacks and ictal phenomena may be difficult. This is illustrated by the patient reported here with concurrent migrainous headache, intermittent VHIs, occipital spikes during attacks, and a region of low perfusion and hyperemia of the corresponding right visual cortex. CASE HISTORYA 41-year-old right-handed man with a history of migraine with aura, (IHS 1988 4 ) with no history of seizures was admitted to hospital. One day before admission, he had noted scintillating scotomas in the left visual field after physical exertion, followed 2 hours later by a left-sided homonymous hemianopia and right hemicranial pain. Subsequently, he had repetitive visual hallucinations and persisting headache. He did not drink alcohol and denied use of drugs.On admission, he still complained of right temporal headache, left homonymous hemianopia, and scintillating scotoma in the left visual field. Left-sided hypesthesia and dysesthesia in the perioral region, the fingertips of the left hand, and the left forearm were also noted. The patient was nauseated and photophobic. He denied vomiting and phonophobia. Funduscopic examination was normal.Routine screening of blood, serum, and CSF as well as a cranial CT scan were normal. At admission, tra...

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“…Correlacionando lesões focais da substância branca e a produção de microembolos e infartos lacunares secundários ao aumento da agregação plaquetária e liberação de agentes vasoconstrictores, como a serotonina 16,17 . No nosso trabalho, não evidenciamos prevalência de alterações demielinizantes e nem de lesões glióticas de etiologia vascular entre os grupos.…”

Section: Discussionunclassified

Dilatação dos espaços de Virchow-Robin em pacientes com migrânea

Júnior¹,

Matos²,

Goyanna³

et al. 2001

Arq. Neuro-Psiquiatr.

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No passado, acreditava-se que os espaços de Virchow-Robin (EVR) eram invaginações dos espaços subaracnóides 1,2 . Estudos com microscopia eletrôni-ca, sugerem que os EVR originam-se de invaginações do espaço subpial, formando uma bainha de revestimento que contém as artérias separando o espaço subaracnóide do subpial 3,4 .A dilatação dos EVR é facilmente detectada pela ressonância magnética (RM) 5 e tem sido descrita em pacientes com criptococose 6 , mucopolissacaridose 7 , crianças com cefaléia 8 , envelhecimento 9 macrocefalia e epilepsia do lobo temporal 10 ou ainda, em achados ocasionais concebidos como variantes do normal 11,12 .Nós revimos 70 RM de pacientes com migrânea e comparamos com igual número de pacientes sem antecedentes de cefaléia. RESUMO -Os espaços de Virchow-Robin (EVR) são invaginações do espaço subpial, formando uma bainha de revestimento tubular contendo um vaso, que separa o espaço subaracnóide do subpial. A ressonância magnética (RM) é o único método de imagem capaz de avaliar este detalhe anatômico. Nós estudamos a possível associação entre EVR dilatados e migrânea. Avaliamos 70 pacientes com idade compreendida entre 13 e 54 anos (média 36,5 anos), com diagnóstico clínico de migrânea e comparamos com grupo controle com igual número de pacientes com idade compreendida entre 14 e 64 anos (média de 42 anos), sem antecedentes de cefaléia. Observamos aumento dos EVR em 28 casos (40%) dos pacientes com migrânea. No grupo controle tal achado foi encontrado em apenas 5 casos (7,1%). Alertamos, ainda, sobre a importância na detecção e reconhecimento dos EVR, bem como o seu diagnóstico diferencial com infartos lacunares e cistos da fissura coroidea. PALAVRAS-CHAVE: espaços perivasculares de Virchow-Robin, ressonância magnética, migrânea. DILATAÇÃO DOS ESPAÇOS DE VIRCHOW-ROBIN EM PACIENTES COM MIGRÂNEA Dilatation of Virchow-Robin spaces in patients with migraineABSTRACT -The Virchow-Robin spaces (VRS) are subpial invaginations making a tubular revestment scabbard that contains a vase between the subarachnoid and subpial spaces. The magnetic resonance imaging (MRI) is the only imaging method able for evaluate this anatomic detail. We studied the possible association between dilated VRS and migraine. Seventy patients with ages ranging from 13 to 54 years (mean, 36.5 years), with clinical diagnosis of migraine were studied and compared with a control group, without past of headache, composed by the same number of patients with ages ranged from 14 to 64 years (mean, 42 years). We observed widening of VRS in 28 cases (40%) of the migraine patients. In the control group this feature was demonstrated in only 5 cases (7.1%). Alert for the importance of detecting and recognizing the VRS, as well as, the diferentiation from lacunar infarctions and coroid fissure cists.

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The Prevalence of Cerebral Damage Varies With Migraine Type: A MRI Study

Cited by 109 publications

References 3 publications

Migraine and structural changes in the brain

Migraine and structural changes in the brain

Meningeal Hyperperfusion Visualized by MRI in a Patient With Visual Hallucinations and Migraine

Dilatação dos espaços de Virchow-Robin em pacientes com migrânea

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