Neuropsichiatria Inf., Università di Cagliari, Azienda Ospedaliero-Universitaria, Via Ospedale 119, 09124, Cagliari, Italy.
J Neurol. 2010 Oct;257(10):1642-7. doi: 10.1007/s00415-010-5582-8. Epub 2010 May 9.
Previous studies suggest a role of scalp perivascular structures in at least a substantial number of migraineurs. This study aimed to evaluate the presence of pressure-painful scalp arteries in patients with migraine. Pressure-painful points on scalp arteries were searched for in 100 consecutive patients affected with migraine, 84 females (F) and 16 males (M), 83 without aura (70 F) and 17 with aura (14 F), and in 30 healthy matched subjects. The examined arteries were, bilaterally, the superficial temporal and its frontal branch, the zygomatico-orbital, the occipital and the posterior auricular. We examined 75 patients interictally: 60 (80.0%) reported one or more (mean per subject 3.7 ± 1.9) pressure-painful arteries and 15 (20.0%) reported none. In the 30 controls, pressure-painful arteries were present in only nine (30.0%, mean per subject 1.3 ± 0.7), with highly significant differences (p < 0.001). During a migraine attack, of the 51 patients examined, 45 (88.2%, 38F) reported one or more (mean 3.8 ± 2.1) pressure-painful arteries and six (11.8%) reported none. Both when during an attack and interictally, the arteries most frequently involved were the occipital, the frontal branch, and the temporal. Scalp arteries are frequently painful to pressure in migraineurs, especially in females, both during headache and interictally. Painful arteries suggest hypersensitivity of periarterial nociceptive afferents, which is perhaps due to the local presence of endogenous algogenic products, as suggested by our previous studies.
先前的研究表明，头皮周围血管结构在至少相当一部分偏头痛患者中起作用。本研究旨在评估偏头痛患者头皮动脉压痛的存在情况。在 100 例连续偏头痛患者（84 名女性[F]和 16 名男性[M]）、83 名无先兆偏头痛（70 名 F 和 13 名 M）和 17 名有先兆偏头痛（14 名 F）和 30 名健康匹配对照中，寻找头皮动脉压痛点。检查的动脉包括双侧颞浅动脉及其额支、颧眶动脉、枕动脉和耳后动脉。我们检查了 75 例间歇期患者：60 例（80.0%）报告有 1 条或多条（每位患者平均 3.7±1.9 条）压痛动脉，15 例（20.0%）报告无压痛动脉。在 30 名对照中，仅 9 名（30.0%，每位患者平均 1.3±0.7 条）存在压痛动脉，差异具有高度显著性（p<0.001）。在 51 例偏头痛发作期间接受检查的患者中，45 例（88.2%，38 名 F）报告有 1 条或多条压痛动脉（平均 3.8±2.1 条），6 例（11.8%）报告无压痛动脉。无论是在头痛发作期间还是间歇期，最常受累的动脉是枕动脉、额支和颞动脉。偏头痛患者的头皮动脉经常因受压而感到疼痛，尤其是女性，无论是在头痛发作期间还是间歇期。压痛动脉提示动脉周围伤害感受传入纤维的高敏性，这可能是由于局部存在内源性致痛物质，正如我们之前的研究所示。
