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Migraine and intracranial vascular malformations
J M Monteiro1, M J Rosas, A P Correia
1Department of Neurology, Hospital Santo António, Porto, Portugal.
Insights
Migraine headaches are common in patients with intracranial vascular malformations (IVM). A strong correlation exists between the AVM site and headache side, suggesting a potential link requiring further study.
Area of Science:
- Neurology
- Neurosurgery
- Vascular Neurology
Background:
- The relationship between migraine and arteriovenous malformations (AVM) remains controversial, often based on limited case reports.
- A structured approach to classifying headaches in patients with intracranial vascular malformations (IVM) is needed to clarify this association.
Purpose of the Study:
- To investigate the prevalence and characteristics of headaches in patients with confirmed intracranial vascular malformations (IVM).
- To explore potential correlations between headache patterns and the type or location of IVM.
Main Methods:
- Retrospective review of 51 patients with IVM admitted between 1984 and 1992.
- Utilized self-administered headache questionnaires and clinical interviews based on International Headache Society (IHS) criteria for diagnosis.
Main Results:
- A high prevalence of 47% for migraine-type headaches was observed in the studied IVM patient cohort.
- A significant positive correlation (88.8%) was found between the anatomical site of the arteriovenous malformation (AVM) and the laterality of headache pain.
Conclusions:
- The findings suggest a potential pathophysiological link between IVM and migraine-type headaches, though not definitively proven.
- Prospective studies employing questionnaires or semi-structured interviews are essential to establish the true prevalence and characteristics of headaches associated with IVM.
Abstract:
The relationships between migraine and A-V Malformations is a subject of controversy and the arguments are mainly based on case reports and retrospective data. To clarify this subject a structured inquiry and classification of headaches in large samples of patients with intracranial vascular malformations (IVM) is essential. The authors studied the prevalence of headaches in 51 patients with IVM admitted to our Department, between 1984 and 1992. The methods used were a review of medical records followed by a self-administered headache questionnaire and clinical interview using the IHS criteria for the diagnostic classification of headaches. The relative frequency of the different types of headaches was calculated and compared with the general population data. A correlative study of the headache characteristics with the type and location of the IVM was made. A high prevalence (47%) of migraine type headaches and a strong positive correlation (88.8%) between the site of AVM and side of the pain was found. This is highly suggestive but not conclusive of a pathophysiologic relationship between these entities. The conclusion drawn is that a prospective study of headaches by questionnaire or semi-structured clinical interview in patients with IVM is essential to discover the effective prevalence and characteristics of headaches associated with IVM and their relationships.