Vol 4, No 3 (2019)
Research paper
Published online: 2019-10-08

open access

Page views 621
Article views/downloads 598
Get Citation

Connect on Social Media

Connect on Social Media

The value of carotid intima-media measurements during the periods of attack and remission of migraine disease and tension-type headache in differential diagnosis

Gülden Kazancı1, Togay Evrin2, Burak Katipoğlu2, Refah Sayın3, Ebru Özan Sanhal4, Ertuğrul Kazancı2, Fatih Demir2, Semih Korkut5, Lukasz Szarpak6
Disaster Emerg Med J 2019;4(3):109-115.

Abstract

INTRODUCTION: In Turkey, 2% of emergency department admissions are migraine and there is no specific biomarker with differential diagnostic value in patients presenting with headache. There are studies showing that the blood-brain barrier deteriorates during migraine attacks, the risk of atherosclerosis is increased in migraine patients and it is associated with cardiovascular and cerebrovascular diseases. In light of this information, the value of carotid intima-media thickness (CIMT) measurements in the differential diagnosis of tension and migraine headache was investigated. 

MATERIAL AND METHODS: The study group consisting of 20 tension headache, 23 migraine attacks, 20 remission migraine patients admitted to the emergency department and neurology outpatient clinic of Ridvan Ege Hospital between February and September 2017 and control group of 21 healthy volunteers were compared. Carotid intima-media thickness (CIMT) of all participants was measured by specialist radiologist. The data obtained were analysed using SPSS 15.0 statistical program. 

RESULTS: There was no significant difference between the participants in terms of age and gender. When the carotid intima-media thickness was analysed between the four groups and according to the presence and type of migraine, no significant difference was found (p = 0.489). 

CONCLUSIONS: This is the first study in the literature which evaluates the relationship between subclinical atherosclerosis and tension-type headache and migraine by examining patients with tension-type headache and migraine disease in both episode and remission period. According to the results obtained, migraine and tension headache is not associated with subclinical atherosclerosis. However, larger-scale studies are required in this sense.

Article available in PDF format

View PDF Download PDF file

References

  1. Yilmaz M, Gurger M, Atescelik M, et al. Meteorologic parameters and migraine headache: ED study. Am J Emerg Med. 2015; 33(3): 409–413.
  2. Zarifoglu MSA, Hayran OTG. An epidemiological study of headache in Turkey: a nationwide survey. Neurology. 1998; 50(A225).
  3. Judith Tintinalli JS, O. John Ma DC, Rita Cydulka GM. Tintinalli’s Emergency Medicine: A Comprehensive Study Guide, Seventh Edition Emergency Medicine (Tintinalli). 7th edition.
  4. http://www.itfnoroloji.org/ekitap.htm.
  5. Kanters SD, Algra A, van Leeuwen MS, et al. Reproducibility of in vivo carotid intima-media thickness measurements: a review. Stroke. 1997; 28(3): 665–671.
  6. Glagov S, Weisenberg E, Zarins CK, et al. Compensatory enlargement of human atherosclerotic coronary arteries. N Engl J Med. 1987; 316(22): 1371–1375.
  7. Touboul PJ, Elbaz A, Koller C, et al. Common carotid artery intima-media thickness and brain infarction : the Etude du Profil Génétique de l'Infarctus Cérébral (GENIC) case-control study. The GENIC Investigators. Circulation. 2000; 102(3): 313–318.
  8. O'Leary DH, Polak JF, Kronmal RA, et al. Carotid-artery intima and media thickness as a risk factor for myocardial infarction and stroke in older adults. Cardiovascular Health Study Collaborative Research Group. N Engl J Med. 1999; 340(1): 14–22.
  9. Parmeggiani L, Salandin M, Egger F, et al. A thicker intima-media carotid wall was found in a cohort of children with recent onset migraine. Acta Paediatr. 2016; 105(12): e577–e581.
  10. Güneş Tatar İ, Ergun O, Çeltikçi P, et al. Evaluation of subclinical atherosclerosis in migraine patients by ultrasound radiofrequency data technology: preliminary results. Agri. 2016; 28(3): 121–126.
  11. Simons PC, Algra A, Bots ML, et al. Common carotid intima-media thickness and arterial stiffness: indicators of cardiovascular risk in high-risk patients. The SMART Study (Second Manifestations of ARTerial disease). Circulation. 1999; 100(9): 951–957.
  12. Mackinnon AD, Jerrard-Dunne P, Sitzer M, et al. Rates and determinants of site-specific progression of carotid artery intima-media thickness: the carotid atherosclerosis progression study. Stroke. 2004; 35(9): 2150–2154.
  13. Martinic-Popovic I, Simundic AM, Dukic L, et al. The association of inflammatory markers with cerebral vasoreactivity and carotid atherosclerosis in transient ischaemic attack. Clin Biochem. 2014; 47(16-17): 182–186.
  14. Beşir FH, Yazgan S, Celbek G, et al. [Normal value correlates of carotid intima- media thickness and affecting parameters in healthy adults]. Anadolu Kardiyol Derg. 2012; 12(5): 427–433.
  15. Schürks M, Rist PM, Bigal ME, et al. Migraine and cardiovascular disease: systematic review and meta-analysis. BMJ. 2009; 339: b3914.
  16. Kurth T, Schürks M, Logroscino G, et al. Migraine, vascular risk, and cardiovascular events in women: prospective cohort study. BMJ. 2008; 337: a636.
  17. Sarchielli P, Alberti A, Baldi A, et al. Proinflammatory cytokines, adhesion molecules, and lymphocyte integrin expression in the internal jugular blood of migraine patients without aura assessed ictally. Headache. 2006; 46(2): 200–207.
  18. Tietjen GE. Migraine as a systemic vasculopathy. Cephalalgia. 2009; 29(9): 987–996.
  19. Vanmolkot FH, Van Bortel LM, de Hoon JN. Altered arterial function in migraine of recent onset. Neurology. 2007; 68(19): 1563–1570.
  20. Hamed SA, Hamed EA, Ezz Eldin AM, et al. Vascular risk factors, endothelial function, and carotid thickness in patients with migraine: relationship to atherosclerosis. J Stroke Cerebrovasc Dis. 2010; 19(2): 92–103.
  21. Goulart AC, Santos IS, Bittencourt MS, et al. Migraine and subclinical atherosclerosis in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Cephalalgia. 2016; 36(9): 840–848.
  22. Stam AH, Weller CM, Janssens AC, et al. Migraine is not associated with enhanced atherosclerosis. Cephalalgia. 2013; 33(4): 228–235.
  23. Perko D, Pretnar-Oblak J, Sabovic M, et al. Endothelium-dependent vasodilatation in migraine patients. Cephalalgia. 2011; 31(6): 654–660.
  24. Liman TG, Neeb L, Rosinski J, et al. Peripheral endothelial function and arterial stiffness in women with migraine with aura: a case-control study. Cephalalgia. 2012; 32(6): 459–466.