Zhang Yaoheng, Ju Yi, Liu Chunling, Li Hui, Jia Yanlu, Sun Shuning, Yin Haozhe, Ma Suisui, Peng Wenbo
Department of Neurology, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Department of Neurology, Beijing Tiantan Hospital, Beijing, China.
Brain Behav. 2025 Aug;15(8):e70782. doi: 10.1002/brb3.70782.
Patients with vestibular migraine (VM) and those with migraine accompanied by unruptured intracranial aneurysm (UIA) may face an increased risk of UIA rupture. This study investigated the rupture risk of UIA in patients with VM and proposed a plausible explanation for the associations between VM, migraine, and UIA distribution, particularly concerning interactions within vascular and nociceptive conduction pathways.
A cross-sectional case-control study involving 148 subjects diagnosed with UIA was conducted, who were categorized into three groups: the VM, the migraine, and the control groups. The distribution of parent arteries and the morphological parameters of the UIA, such as diameter, size, depth, neck width, mean parent arterial diameter, size ratio, non-spherical index (NSI), and parameters specific to bifurcation UIA, were extracted from the original imaging data and 3D-Slicer software for intergroup comparison.
UIA was predominantly located in the internal carotid arteries (ICA) at C4 (12.3%), C5 (14.0%), and C7 (35.1%) in the VM group. The migraine group exhibited UIA primarily in the ICA at C6 (42.2%) and the vertebrobasilar artery (10.9%). In the control group, UIA was concentrated in the middle cerebral artery (22.6%). These distributions differed significantly (p = 0.002, p = 0.017). Furthermore, a statistically significant difference was observed in the NSI between the VM and migraine groups (p = 0.044).
We observed significant differences in the distribution of UIA between the VM and migraine groups compared to the control group. Furthermore, intergroup comparisons of morphological parameters indicated that both VM and migraine patients have a higher risk of aneurysm rupture. We propose a plausible hypothesis regarding the relationship between VM, migraine, and UIA distribution. Future research should involve more precise hemodynamic analyses, long-term patient follow-up, and potential animal studies.
前庭性偏头痛（VM）患者以及伴有未破裂颅内动脉瘤（UIA）的偏头痛患者可能面临UIA破裂风险增加的情况。本研究调查了VM患者中UIA的破裂风险，并对VM、偏头痛和UIA分布之间的关联提出了合理的解释，特别是关于血管和伤害性传导通路内的相互作用。
进行了一项横断面病例对照研究，纳入148例诊断为UIA的受试者，将其分为三组：VM组、偏头痛组和对照组。从原始影像数据和3D-Slicer软件中提取母动脉的分布以及UIA的形态学参数，如直径、大小、深度、颈部宽度、母动脉平均直径、大小比、非球形指数（NSI）以及分叉处UIA的特定参数，进行组间比较。
VM组中UIA主要位于颈内动脉（ICA）的C4（12.3%）、C5（14.0%）和C7（35.1%）水平。偏头痛组的UIA主要位于ICA的C6水平（42.2%）和椎基底动脉（10.9%）。对照组中，UIA集中在大脑中动脉（22.6%）。这些分布存在显著差异（p = 0.002，p = 0.017）。此外，VM组和偏头痛组之间的NSI存在统计学显著差异（p = 0.044）。
我们观察到，与对照组相比，VM组和偏头痛组在UIA分布上存在显著差异。此外，形态学参数的组间比较表明，VM和偏头痛患者的动脉瘤破裂风险均较高。我们提出了一个关于VM、偏头痛和UIA分布之间关系的合理假设。未来的研究应包括更精确的血流动力学分析、患者长期随访以及潜在的动物研究。
