Page 95 - Migraine, the heart and the brain

MFS patients only used lled in questionnaires by post, introducing possible diagnostic
inaccuracy and response bias. For the Dutch study sample, a specially trained student
who performed the telephone interviews was blinded for AR status (but not for MFS
diagnosis); however the nal migraine diagnosis was made by a headache neurologist
blinded for all clinical characteristics. Migraine with aura prevalence could have been
slightly underestimated, as the interview was only continued after the rst screening
step if participants had suffered at least ve headache attacks. According to the ICHD-
II criteria, for migraine without aura ve attacks are needed, but only two attacks
are necessary to ful l migraine with aura criteria (16). Both MFS patients and aortic
root patients without MFS were identi ed using hospital-based databases, whereas
controls were not hospital based. Controls were selected by the Marfan patients,
which could have introduced selection bias. This might have caused some disparity
for unknown factors. If migraine activity altered due to the aortic root operation,
this could not be investigated by this study, but a prospective study answering this
question is highly interesting. 5
Aorta root pathology requiring AR was found to be a risk factor for migraine with aura. MFS independent from aortic root operation was no risk factor for migraine with aura. This study adds to the evidence that underlying vessel wall pathology might play a role in migraine with aura.
Marfan syndrome and migraine
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