Lang Yilin, Zhang Sai, Xie Peifan, Wang Yang, Wang Chuangwei, Wang Wenting, Zhu Xien, Gu Ping
Department of Neurology, The First Hospital of Hebei Medical University, Shijiazhuang, China.
Front Neurol. 2024 Dec 12;15:1500918. doi: 10.3389/fneur.2024.1500918. eCollection 2024.
This study aims to evaluate the short-term efficacy of right-to-left shunt closure in vestibular migraine patients, and compare the efficacy between patent foramen ovale (PFO) closure and pulmonary arteriovenous malformation (PAVM) embolization. Additionally, the study identifies factors related to surgical outcomes.
Forty-one patients with vestibular migraine and medium to large right-to-left shunts underwent surgery: PFO closure, PAVM embolization, or both. Baseline data and postoperative outcomes at one month, including migraine and dizziness frequency, duration, VAS, HIT-6, migraine scores, and DHI scores, were analyzed. The correlation between efficacy and baseline data was analyzed.
At one month postoperatively, the frequency and duration of dizziness and migraine attacks significantly decreased, and the VAS, HIT-6, migraine scores, and DHI scores all significantly dropped ( < 0.001). There was no significant difference in the improvement rates of VAS, HIT-6, migraine scores, and DHI scores between the PFO group and the PAVM group ( > 0.05). Red blood cell parameters positively correlated with the improvement rates of VAS, HIT-6, migraine scores, and DHI. This approach was more effective in male patients than in female patients ( < 0.05).
Right-to-left shunt closure has a significant short-term effect on patients with vestibular migraine, regardless of the shunt location. Red blood cell parameters may serve as predictive indicators for the surgical efficacy in these patients.
本研究旨在评估右向左分流封堵术对前庭性偏头痛患者的短期疗效，并比较卵圆孔未闭（PFO）封堵术和肺动静脉畸形（PAVM）栓塞术之间的疗效。此外，该研究还确定了与手术结果相关的因素。
41例患有前庭性偏头痛且存在中至大量右向左分流的患者接受了手术：PFO封堵术、PAVM栓塞术或两者皆有。分析了基线数据以及术后1个月的结果，包括偏头痛和头晕的频率、持续时间、视觉模拟评分（VAS）、头痛影响测试-6（HIT-6）、偏头痛评分和头晕残障指数（DHI）评分。分析了疗效与基线数据之间的相关性。
术后1个月，头晕和偏头痛发作的频率及持续时间显著降低，VAS、HIT-6、偏头痛评分和DHI评分均显著下降（P<0.001）。PFO组和PAVM组之间VAS、HIT-6、偏头痛评分和DHI评分的改善率无显著差异（P>0.05）。红细胞参数与VAS、HIT-6、偏头痛评分和DHI的改善率呈正相关。该方法对男性患者比对女性患者更有效（P<0.05）。
无论分流位置如何，右向左分流封堵术对前庭性偏头痛患者均有显著的短期疗效。红细胞参数可作为这些患者手术疗效的预测指标。
