Abstract

CEREBRAL WHITE MATTER BRAIN CHANGES ON MAGNETIC RESONANCE IMAGE IN MIGRAINE AND OTHER PRIMARY HEADACHES PATIENTS

Dr. Suha Salim Jaafer*, Dr. Hayder Saad Hanfoosh and Dr. Iman Muhsin Ali Allamy

ABSTRACT

Background: Migraine is a primary headache disorder characterized by recurrent headaches attacks that are moderate to severe. Objective: This study is designed to assess the abnormal imaging findings in the cerebral white matter (WM) of particularly migrainous and universally chronic headaching patients and the correlation between the migraine and the abnormal magnetic resonance image (MRI) brain changes with different variables (age of the patient, sex, body mass index (BMI), smoking, contraceptive pills, family history of migraine, type of migraine and disease duration. Patients and methods: A hospital-based cross sectional study at the neurology outpatient department of a Middle Euphartes Neuroscience center, Al-Sasader Medical City, Al-Najaf government, Iraq conducted along 9 months (between January and September 2016)There were 104 patients enrolled in this study. age range from 12 years to 49 years 11 months. Results: Females were more frequent than males, 63 (60.6%) vs. 41 (39.4%), respectively, twenty nine patients (27.9%) have migraine without aura, 14 patients (13.5%) have migraine with aura and 61 patients (58.7%) have other types of primary headaches. ten patients (31.2%) have family history of migraine ten patients (9.6%) have abnormal brain changes (supratentorial: subcortical, and periventricular ,pericallosal white matter hyperintensities (WMHs) as frontal, parietal, temporal, occipital, or infratentorial) while the remaining 94 patients (90.4%) don’t have abnormal brain changes. The MRI brain changes found to be significantly associated with age of the pt since 8 (22.2 %) of the pts within the age group of 40 – 49 years, (P=0.007). While no significant association neither with gender nor with the BMI, (P>0.05). Patients who have migraine with aura were more likely to have positive MRI brain changes compared to those who have migraine without aura and those have other types of primary headaches, the proportion of positive findings, six patients (42.9%), 1(3.4%), and 3 patients (4.9%) respectively, (P< 0.001). However, the disease duration is insignificantly associated with MRI brain changes, (P> 0.05) The relationship of positive MRI brain changes and family history of migraine didn’t reach the statistical significance, (P> 0.05). Conclusions: The cerebral WM changes on MRI were found to be significantly associated with age of the patient, While no significant association neither with gender nor with the BMI was seen. Patients who have migraine with aura were more likely to have positive MRI brain changes compared to those who have migraine without aura and those who have any other type of primary headache. Supratentorial, combined supratentorial and infratentorial WM brain changes were less frequent in patients with headache compared to migraine patients.

Keywords: Migraine, headache, brain white matter changes, BMI.