Prevalence of headache in patients with sporadic cerebral small vessel disease

• Main Authors: Stevanović Aleksandar, Pavlović Aleksandra M.
• Format: Article
• Language: English
• Published: University of Belgrade, Medical Faculty 2019-01-01
• Series: Medicinski Podmladak
• Subjects: headache; cerebral small vessel disease; lacunar infarction; white matter hyperintensities
• Online Access: https://scindeks-clanci.ceon.rs/data/pdf/0369-1527/2019/0369-15271904047X.pdf

Introduction: Cerebral small vessel disease (CSVD), a common finding in patients with vas-cular risk factors, is associated with motor, cognitive and affective disorders. Magnetic resonance imaging (MRI) brain scans of patients with CSVD include lacunar infarcts and/or white matter hyperintensities (WMH) and microhemorrhages. Aside from rare familiar forms of CSVD, patients with headaches, especially migraineurs, have an increased risk to develop these lesions, although this relationship is rather complex and yet to be fully elucidated. Aim: The aim of the study was to determine the frequency and type of headache in patients with CSVD. Material and methods: This retrospective study included 115 patients with CSVD diagnosis admitted at the Clinic of Neurology, Clinical Center of Serbia in the period January 1 st , 2015-December 31 st , 2017. Baseline demographic data, headache type and MRI findings (ischemic lacunar infarctions, WMH, and overall lesion severity) were obtained. Data were compared between CSVD patients with headache and headache-free CSVD cases, with the use of standard statistical methods. Results: Among all patients included in this study, 44% had headaches. Lacunar infarcts were present in 86,1% and WMH in 46,1% cases. Correlation between headache symptoms and lacunar infarcts showed a trend towards statistical significance (p = 0.072) whereas headache free patients more frequently had WMH, also approaching statistical significance (p = 0.065). Conclusion: A large number of arteriolosclerotic CSVD patients complain of different types of headaches. Based on MRI findings, lacunar infarcts are related to headache symptoms, and WMHs are more frequently present in patients with a negative history of headache.