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Neurology:偏头痛患儿脑白质病变与卒中发作不相关

2013-10-21 sunight dxy

研究要点:1.先兆偏头痛患者脑白质病变患病率较无先兆偏头痛患儿并没有提高。2.偏头痛患儿脑白质病变更倾向于良性,与卒中发作不相关。该研究的目的是探究儿童偏头痛患者中枢神经系统脑白质病变及脑梗死的情况,同时探究儿童患者的偏头痛是否是沉默型脑梗死或卒中的危险因素。该研究为前瞻性研究,纳入1008例患有头痛的儿童患者,搜集其临床数据。颅脑MRI为前瞻性或回顾性数据。 【原文下载】共有926例头

研究要点:

1.先兆偏头痛患者脑白质病变患病率较无先兆偏头痛患儿并没有提高。

2.偏头痛患儿脑白质病变更倾向于良性,与卒中发作不相关。

该研究的目的是探究儿童偏头痛患者中枢神经系统脑白质病变及脑梗死的情况,同时探究儿童患者的偏头痛是否是沉默型脑梗死或卒中的危险因素。
该研究为前瞻性研究,纳入1008例患有头痛的儿童患者,搜集其临床数据。颅脑MRI为前瞻性或回顾性数据。 【原文下载】

共有926例头痛患者诊断为偏头痛,375例患者具有MRI数据,其中115例有异常,异常患者中有39例有脑白质病变。在39例有脑白质病变的患儿中,24例(占偏头痛患者的6%)为偶然发现的脑白质病变而没有明显的神经血管疾病、危险因素或脑白质病变的病因。

脑白质病变的发病率先兆偏头痛患者高于无先兆偏头痛患者,但是与对照组相比没有统计学差异。深部脑白质病变比脑室旁病变更常见,主要发生在额叶和顶叶。这些病变没有类似梗死性病变的。脑白质病变情况与偏头痛的慢性过程及发作频率没有明显相关性。该类脑白质病变为非进展型。根据随后的随访数据,伴先兆的儿童偏头痛患者并未卒中发作。

与无先兆的对照患儿相比,先兆偏头痛患者脑白质病变患病率并没有提高。脑白质病变更倾向于良性,与卒中发作不相关。

研究背景:

偏头痛是血管性头痛的一种。其主要临床特征是头痛反复发作,而且多在头部一侧,每次发作的性质及过程相似,常伴恶心、呕吐、厌食,在头痛之前或之后可有神经系统功能紊乱和情绪改变等,间歇期完全正常。 儿童和成人一样可以发作偏头痛。近期研究指出,偏头痛是成人头痛患者卒中发展和亚临床脑白质病变的危险因素。但对儿童的影响尚不明确。
 
原文检索:

Mar S, Kelly JE, Isbell S, Aung WY, Lenox J, Prensky A.Prevalence of white matter lesions and stroke in children with migraine.Neurology. 2013 Oct 15;81(16):1387-91. doi: 10.1212/WNL.0b013e3182a8412e. 【原文下载】

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