caa a22 4500 445808764 CHVBK 20180317145205.0 cr unu---uuuuu 170323e20110301xx s 000 0 eng 10.1007/s00415-010-5771-5 doi (NATIONALLICENCE)springer-10.1007/s00415-010-5771-5 Small deep white matter lesions are associated with right-to-left shunts in migraineurs [Elektronische Daten] [Hee-Kwon Park, Seo-Young Lee, Seong-Eun Kim, Chang-Ho Yun, Sung Kim] The right-to-left shunts (RLS) and white matter lesions (WMLs) are frequently observed in migraineurs and in patients with ischemic stroke. Previous studies have reported that the burden of WMLs did not increase with the intracardiac right-to-left shunt (RLS) in migraineurs. However, some types of WMLs are known to be associated with RLS in patients with stroke and dementia. The aim of the study was to demonstrate the difference in the size and location of WMLs, according to the existence of RLS in patients with headache. From the prospective headache registry, a total of 425 subjects (age, 30.8±5.1years; 303 women; 242 migraineurs; 183 patients with tension-type headache (TTH)) were retrospectively reviewed and evaluated for RLS and WMLs using M-mode power transcranial Doppler sonography (mTCD) and brain magnetic resonance imaging scans. We scored WMLs, according to the Rotterdam Scan Study, and assessed the association between RLS presence and the location and size of WMLs. The number of small deep WMLs (dWMLs) and the prevalence of RLS, defined as microembolic signals (MES) ≥11, were higher in patients with migraine (small dWMLs, 6.23 vs. 4.05; RLS, 36.8% vs. 10.9%), compared to patients with TTH. There was no significant difference in the sum of periventricular WML grades or the total volume of dWMLs between TTH and migraine patients. Among the migraineurs, the patients with RLS more frequently had small dWMLs, aura, and heart disease compared to those without RLS. In addition, RLS were also independent predictors for the presence of small dWMLs from the multivariate binary regression analysis (p<0.01; OR=3.24; 95%CI 1.56-6.72). Small dWMLs are associated with RLS in young migraineurs. These results imply that paradoxical embolism may cause the small WMLs in some migraineurs. Springer-Verlag, 2010 Right-to-left shunts nationallicence White matter lesions nationallicence Migraine nationallicence Paradoxical embolism nationallicence dWMLs : Deep white matter lesions nationallicence MESs : Microembolic signals nationallicence mTCD : m-mode power transcranial Doppler sonography nationallicence RLS : Right-to-left shunts nationallicence pvWMLs : Periventricular white matter lesions nationallicence TTH : Tension-type headache nationallicence WMLs : White matter lesions nationallicence Park Hee-Kwon Department of Neurology, Inha University Hospital, 7-206, 3-Ga, Sinheung-Dong, jung-gu, 400-711, Incheon, South Korea aut Lee Seo-Young Department of Neurology, Kangwon National University Hospital, Chuncheon, South Korea aut Kim Seong-Eun Department of Neurology, Kangwon National University Hospital, Chuncheon, South Korea aut Yun Chang-Ho Department of Neurology, Inha University Hospital, 7-206, 3-Ga, Sinheung-Dong, jung-gu, 400-711, Incheon, South Korea aut Kim Sung Department of Neurology, Kangwon National University Hospital, Chuncheon, South Korea aut Journal of Neurology Springer-Verlag 258/3(2011-03-01), 427-433 0340-5354 258:3<427 2011 258 415 https://doi.org/10.1007/s00415-010-5771-5 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00415-010-5771-5 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Park Hee-Kwon Department of Neurology, Inha University Hospital, 7-206, 3-Ga, Sinheung-Dong, jung-gu, 400-711, Incheon, South Korea aut NATIONALLICENCE 700 1- Lee Seo-Young Department of Neurology, Kangwon National University Hospital, Chuncheon, South Korea aut NATIONALLICENCE 700 1- Kim Seong-Eun Department of Neurology, Kangwon National University Hospital, Chuncheon, South Korea aut NATIONALLICENCE 700 1- Yun Chang-Ho Department of Neurology, Inha University Hospital, 7-206, 3-Ga, Sinheung-Dong, jung-gu, 400-711, Incheon, South Korea aut NATIONALLICENCE 700 1- Kim Sung Department of Neurology, Kangwon National University Hospital, Chuncheon, South Korea aut NATIONALLICENCE 773 0- Journal of Neurology Springer-Verlag 258/3(2011-03-01), 427-433 0340-5354 258:3<427 2011 258 415 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer