Mortezaei Ali, Essibayi Muhammed Amir, Osama Mahmoud, Abdollahifard Saeed, Karandish Alireza, Terraciano Anthony, Fortunel Adisson, Altschul David J
Student Research Committee, Gonabad University of Medical Sciences, Gonabad, Iran.
Department of Neurological Surgery and Montefiore-Einstein Cerebrovascular Research Lab, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.
Interv Neuroradiol. 2024 Dec 18:15910199241305928. doi: 10.1177/15910199241305928.
Migraine is a common neurological disorder that primarily affects young adults. Despite the availability of multiple therapeutic options for patients with intractable migraine, a significant proportion of these patients remain refractory to treatment, highlighting the importance for novel therapies. In this study, we comprehensively assessed the role of the middle meningeal artery (MMA) in the management of intractable migraine. Although the exact pathophysiology of migraine remains a subject of debate, the neurovascular theory of migraine has gained attention recently following multiple studies assessing the role of the MMA in migraine pathophysiology. In addition, the successful utilization of lidocaine both through intravenous injection and directly into the MMA, as well as favorable results observed in the form of headache relief following MMA embolization (MMAE) in patients with chronic subdural hematoma, has further substantiated the neurovascular theory hypothesis. In this study, we evaluated the current evidence, potential trends, role of other injection medications, as well as risks and limitations of MMAE in the management of patients with refractory migraine. Intractable migraine is a complex condition that often requires multimodal management. MMAE has emerged as a promising, novel therapeutic technique that may help reduce pain and minimize the need for additional treatments. However, further prospective and randomized trials are still necessary for further validation.
偏头痛是一种常见的神经系统疾病，主要影响年轻人。尽管对于难治性偏头痛患者有多种治疗选择，但这些患者中有很大一部分对治疗仍无反应，这凸显了新型疗法的重要性。在本研究中，我们全面评估了脑膜中动脉（MMA）在难治性偏头痛治疗中的作用。尽管偏头痛的确切病理生理学仍是一个有争议的话题，但在多项评估MMA在偏头痛病理生理学中作用的研究之后，偏头痛的神经血管理论最近受到了关注。此外，利多卡因通过静脉注射以及直接注入MMA的成功应用，以及慢性硬膜下血肿患者在进行脑膜中动脉栓塞术（MMAE）后以头痛缓解形式观察到的良好结果，进一步证实了神经血管理论假说。在本研究中，我们评估了当前的证据、潜在趋势、其他注射药物的作用以及MMAE在难治性偏头痛患者治疗中的风险和局限性。难治性偏头痛是一种复杂的病症，通常需要多模式管理。MMAE已成为一种有前景的新型治疗技术，可能有助于减轻疼痛并减少额外治疗的需求。然而，仍需要进一步的前瞻性和随机试验来进一步验证。
