White Matter Lesions and Migrain

OBJECTIVE: There are close correlations between subclinical ischaemic strokes and white matter lesions (WML) in migraineurs as shown by imaging studies. T2-weighted images of migraine patients displayed hyperintense lesions in 6-29% of the cases in different studies. It is well known that the presence of migrain, especially migrain with aura, is an important risk factor for ischaemic stroke.
OBJECTIVE: The aim of this study is to investigate the clinical and diagnostic features of migrain patients with and without WML in T2-weighted MR images.

METHODS: Patients, according to the criteria of ICD-II, diagnosed as migrain with and without aura were subjected in this prospective study. Following to obtain informed consents, patients were grouped according to the presence or absence of WML as group 1 and group 2, respectively. Each group has been evaluated considering their demographic data, medical history, physical and neurological findings, the features of headache, hemogram, biochemical analysis and the level of hemosistein.
RESULTS: When the headache characteristics and demographic data were compared, no differences were encountered between two groups. However, mean homosistein level was found to be higher in patient with WML in MRI.
CONCLUSION: Except the higher levels of homosistein, the presence of WML in migrain patient did not differ for the vascular risk factor and other clinical features. Hence, the association betwen migrain and ischaemic stroke seems to be hypothetical rather than evidence based although there seem to be a proximity between migraine with aura and white matter lesions in our subjects.