Kruit Mark C, Launer Lenore J, Ferrari Michel D, van Buchem Mark A
Department of Radiology, Leiden University Medical Center, PO Box 9600, The Netherlands.
Stroke. 2006 Apr;37(4):1109-12. doi: 10.1161/01.STR.0000206446.26702.e9. Epub 2006 Feb 23.
Migraineurs are at increased risk of cerebellar infarcts and supratentorial white matter lesions. The prevalence, frequency, and distribution of infratentorial hyperintense lesions in migraine are unknown.
Migraineurs with aura (n=161), without aura (n=134), and controls (n=140) from a population-based sample of adults (30 to 60 years of age) were evaluated with MRI.
Infratentorial hyperintensities were identified in 13 of 295 (4.4%) migraineurs and in 1 of 140 (0.7%) controls (P=0.04). Twelve cases had hyperintensities, mostly bilaterally, in the dorsal basis pontis. Those with infratentorial hyperintensities also had supratentorial white matter lesions more often.
We found an increased prevalence of infratentorial (mostly pontine) hyperintensities in migraineurs from the general population. This extends the knowledge about vulnerable brain regions and type of lesions in migraine brains. A hemodynamic ischemic pathogenesis is likely, but further research is needed.
偏头痛患者发生小脑梗死和幕上白质病变的风险增加。偏头痛患者幕下高信号病变的患病率、发生频率及分布情况尚不清楚。
对来自基于人群的成人样本（30至60岁）中的有先兆偏头痛患者（n = 161）、无先兆偏头痛患者（n = 134）和对照组（n = 140）进行磁共振成像（MRI）评估。
295例偏头痛患者中有13例（4.4%）发现幕下高信号，140例对照组中有1例（0.7%）发现幕下高信号（P = 0.04）。12例患者在脑桥背侧出现高信号，大多为双侧。幕下有高信号的患者也更常出现幕上白质病变。
我们发现普通人群中偏头痛患者幕下（主要是脑桥）高信号的患病率增加。这扩展了对偏头痛患者脑部易损区域和病变类型的认识。血流动力学缺血性发病机制可能存在，但仍需进一步研究。
