The white matter changes are the early predictors for the brain damage, caused by hypertension in the patients with headache

초록

Purpose : Many patients with headache wonder whether the hypertension are related to headache and what kind of change in brain could be resulted from headache. However, the lesion associated with hypertension in the patients with headache remained undefined. The aim of the study to demonstrate the difference of brain change on MR scans, according to the hypertension in the patients with headache. Methods : From the prospective headache registry, we selected the patients, who were younger than40 years old and were evaluated for headache pattern, cardiovascular risk factors and brain MR scans. A total of 425 subjects(30.8±5.1y and 291 women) were enrolled and reviewed retrospectively, who were 242 migrainers and 183 patients with tension-type headache(TTH). We scored white matter changes(WMCs), according to the Rotterdam Scan Study and assessed the association between hypertension presence and the lesion of brain on MR scans. Results : The patients with hypertension(n=42) were older and had the history of diabetes and hyperlipidemia more frequently than those without (Age, 33.9±3.0 vs 30.5±5.2y, P<0.01; Diabetes mellitus, 11.9% vs 3.1%, P=0.019; Hyperlipidemia, 14.3% vs 5.0%, P=0.027). The frequency of women and migraine were not different between two groups. The patients with hypertension had the higher periventricular WMC grades and larger volume of deep WMCs, comparing with those without(periventricular WMC grades, 1.76±1.86 vs 0.74±1.12, P<0.01; Total volume of deep WMCs, 1.27±2.11 vs 0.34±1.16, P=0.008). However, the presence of microbleeds, cerebral artery stenosis or silent cerebral infarction was not different between two groups. After adjusting age, diabetes and hyperlipidemia, the ANCOVA analysis revealed that hypertension was independent predictor for higher periventricular WMC grades(P<0.01) and larger volume of deep WMCs(P=0.002)