自发性颈内动脉夹层后偏头痛改善：意大利青年卒中研究项目（IPSYS）。

Migraine improvement after spontaneous cervical artery dissection the Italian Project on Stroke in Young Adults (IPSYS).

机构信息

Dipartimento di Scienze Cliniche e Sperimentali, Clinica Neurologica, Università degli Studi di Brescia, P.le Spedali Civili, 1,, 25123, Brescia, Italy.

Centro di Biostatistica ed Epidemiologia Clinica, Facoltà di Medicina e Chirurgia, Università di Milano-Bicocca, Monza, Italy.

出版信息

Neurol Sci. 2019 Jan;40(1):59-66. doi: 10.1007/s10072-018-3578-9. Epub 2018 Sep 21.

DOI:10.1007/s10072-018-3578-9

PMID:30242572

Abstract

OBJECTIVE

Whether migraine modifies after spontaneous cervical artery dissection (sCeAD) more than after other stroke etiologic subtypes has never been adequately investigated.

METHODS

In the setting of the Italian Project on Stroke in Young Adults (IPSYS), we compared the course of migraine before and after acute brain infarct in a group of migraine patients with sCeAD and a group of migraine patients whose ischemia was due to a cause other than CeAD (non-CeAD IS), matched by sex, age (± 3 years), and migraine subtype.We applied linear mixed models to evaluate pre-event vs post-event changes and differences between sCeAD and non-CeAD IS patients.

RESULTS

Eighty-seven patients per group (migraine without aura/migraine with aura, 67/20) qualified for the analysis. After the acute event, migraine headaches disappeared in 14.0% of CeAD patients vs 0.0% of non-CeAD IS patients (p ≤ 0.001). Migraine frequency (patients suffering at least 1 attack, from 93.1 to 80.5%, p = 0.001), pain intensity (from 6.7 ± 1.7 to 4.6 ± 2.6 in a 0 to 10 pain scale, p ≤ 0.001), and use of acute anti-migraine medications (patients taking at least 1 preparation, from 81.6 to 64.4%, p = 0.007) also improved significantly after CeAD as opposed to that observed after non-CeAD IS.

CONCLUSION

The spontaneous improvement of migraine after sCeAD reinforces the hypothesis of a pathogenic link between the two conditions.

摘要

目的

自发性颈内动脉夹层（sCeAD）后偏头痛的改变是否超过其他卒中病因亚型，尚未得到充分研究。

方法

在意大利青年卒中项目（IPSYS）中，我们比较了 sCeAD 偏头痛患者组和偏头痛患者缺血病因非 sCeAD（非 sCeAD IS）组的急性脑梗死前后偏头痛的病程。通过性别、年龄（±3 岁）和偏头痛亚型匹配。我们应用线性混合模型来评估事件前与事件后的变化以及 sCeAD 与非 sCeAD IS 患者之间的差异。

结果

每组符合条件的患者 87 例（无先兆偏头痛/有先兆偏头痛，67/20）。急性事件后，sCeAD 患者偏头痛头痛消失的比例为 14.0%，而非 sCeAD IS 患者为 0.0%（p ≤ 0.001）。偏头痛发作频率（至少发作 1 次的患者，从 93.1%降至 80.5%，p = 0.001）、疼痛强度（0 至 10 疼痛量表从 6.7 ± 1.7 降至 4.6 ± 2.6，p ≤ 0.001）和急性偏头痛治疗药物的使用（至少服用 1 种药物的患者，从 81.6%降至 64.4%，p = 0.007）在 sCeAD 后也显著改善，而非 sCeAD IS 后则无明显改善。