The white matter hyperintensities are the best landmarks for the brain damage, caused by hypertension

초록

Backgrounds: The lesion associated with hypertension in the patients with headache remained undefined. Here, we demonstrated 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 40 years old or younger 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 hyperintensities(WMHs), 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. The frequency of women and migraine were not different between two groups. The patients with hypertension had the higher periventricular WMHs grades and larger volume of deep WMHs, comparing with those without. 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 and larger volume of deep WMHs. Conclusion: Our results imply that among brain lesions, WMHs may be the sensitive predictor for brain change caused by hypertension in middle aged patients with headache.