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Monday, February 02, 2004Researchers have identified brain lesions in migraine victims, a finding that could indicate the severe headaches are a progressive brain-damaging disease in some cases, new research suggests. The research, which has possible implications for treatment, involved 295 Dutch adults aged 30 to 60, some of whom had migraines with visual disturbances and some migraines without eye problems. They were compared to 140 similar people who were migraine-free. Using magnetic resonance images, the researchers found that for patients with both migraines and visual problems the risk of cerebral infarction -- tissue which has died due to lack of oxygen when a blood clot blocks an artery -- was 13 times higher than the group which had no migraines at all. The problem increased with the frequency of migraine attacks. Patients with migraine but no eye trouble had more than seven times the risk that would normally be expected. The problem occurred in the cerebellar region of the brain, which controls motor motions. Yikes. That's bad news. Oh, but wait. It's not as bad as it sounds. Here's what the study found: "We found no significant difference between patients with migraine and controls in overall infarct prevalence (8.1% vs 5.0%). They did see a higher incidence of what are called "white matter lesions", or WML in the paper, in the region of the brain supplied by the posterior cerebral artery, in people who had migraines associated with visual disturbances. But even then, the numbers were small - 0.7% of controls had lesions in this area, vs. 5.4% of all patients with migraines and 8.1% of migraine sufferers with visual auras. So, 92% of people with the highest risk types of migraine have no lesions at all. There actually is some physiological basis for these findings. We don't really have a good understanding of the physiology of migraines, but it's believed that they occur when part of the brain gets too little oxygen, either because of small clots or a spasm in a small artery. If you click on that "aura" link, you'll see that the visual aura is often associated with loss of visual fields, a condition that could be caused by oxygen deprivation to visual centers in the brain. Some migraines are even associated with stroke-like symptoms, (although this type of migraine was not included in the study). And the worst migraines, those associated with neurological symptoms, appear to involve the posterior circulation of the brain. So, it makes sense that MRI abnormalities would show up in those regions in people who suffer from visual disturbances with their migraines. The wonder is that only 8% of them have it. There's one other thing about the research. Although small areas of damage were found in a minority of migraine sufferers, there's no indication of the functional importance of these lesions. Is there a higher incidence of dementia in migraine sufferers? Of incapacitating strokes? For all we know, people can live with these lesions, and their migraines, for the rest of their lives with no lasting untoward effects. posted by Sydney on 2/02/2004 07:53:00 AM 0 comments 0 Comments: |
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