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首页> 外文期刊>The Canadian Journal of Neurological Sciences: le Journal Canadien des Sciences Neurologiques >Anatomical variants of the circle of willis and brain lesions in migraineurs.
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Anatomical variants of the circle of willis and brain lesions in migraineurs.

机译：偏头痛患者的威利斯环和脑部病变的解剖学变异。

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BACKGROUND: Some reports demonstrated vascular alterations in brain magnetic resonance imaging (MRI) in migraineurs and a relationship between circle of Willis (Circle) variants and lacunar brain infarcts. We examined anomalies of the whole circle of Willis and their relationship with vascular brain lesions in migraineurs, to identify any possible vascular mechanism in migraine. METHODS: We studied, with a cohort controlled study, the circle of Willis in migraineurs seen consecutively in our Headache Center, and in non-headache controls, using angio-MRI of the brain. Statistical analysis used ANOVA, Scheffe's criterion, t-student test. RESULTS: We recruited 270 migraineurs (204 without aura (MWOA), 66 with aura (MWA) and 159 controls. Migraineurs presented an anatomical variant in 108 (40%) cases with 34 controls (21.4%) presenting a variant. We found a significant association between MWOA and variants (OR=2.4 CI95% [1.5 to 3.9]) and between MWA and variants (OR=3.2 CI95% [1.6 to 4.1]). Unilateral posterior variants with basilar hypoplasia are statistically associated only with MWA compared to controls (OR=9.2, CI95% [2.3 to 37.2]). Thirty-three percent of MWOA and 24% of MWA sufferers present some kind of brain lesion, included 2% of infra-tentorial lesions. We did not find any statistical association between the presence of Circle variants and ischemic lesions on MRI (OR=1.5 CI95% [0.68; 1.94]), or with infratentorial lacunar lesions (OR=1.58 CI95% [0.48 to 5.24]). CONCLUSIONS: Anatomical variants of the Circle of Willis are significantly more frequent in migraineurs; posterior anomalies are more frequent in MWA, suggesting a vascular mechanism provoking changes in cerebral blood flow, thereby stimulating cortical spreading depression.
机译：背景：一些报道表明，偏头痛患者的脑磁共振成像（MRI）中的血管改变以及Willis圆（Circle）变体与腔隙性脑梗死之间的关系。我们在偏头痛患者中检查了Willis整个圆的异常及其与血管性脑病变的关系，以确定偏头痛的任何可能的血管机制。方法：我们通过队列对照研究，使用脑血管MRI对在头痛中心和非头痛对照组中连续出现的偏头痛患者的威利斯环进行了研究。统计分析使用方差分析，Scheffe准则，t型学生检验。结果：我们招募了270名移民（204名无先兆（MWOA），66名有先兆（MWA）和159名对照。偏头痛在108名（40％）病例中表现出解剖变异，其中34名对照（21.4％）表现出变异。 MWOA与变体之间的显着相关性（OR = 2.4 CI95％[1.5至3.9]）以及MWA与变体之间的显着相关性（OR = 3.2 CI95％[1.6至4.1]）。对照（OR = 9.2，CI95％[2.3至37.2]）。33％的MWOA和24％的MWA患者存在某种脑部病变，包括2％的脑膜下病变，我们没有发现任何统计关联结论：圆环的解剖变异在MRI上存在Circ变异与缺血性病变之间（OR = 1.5 CI95％[0.68; 1.94]）或在腔内腔隙性病变（OR = 1.58 CI95％[0.48至5.24]）之间。偏头痛患者中威利斯的发病率明显更高; MWA，s中后异常现象更常见提出引起脑血流变化的血管机制，从而刺激皮层扩散抑制。

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