Araştırma Makalesi
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Migren hastalığı ile kafa tabanı açıları arasında bir ilişki var mı?

Yıl 2018, Cilt: 10 Sayı: 4, 456 - 470, 01.12.2018
https://doi.org/10.21601/ortadogutipdergisi.411138

Öz

Amaç: Migren hastalarında, manyetik rezonans görüntülerine göre kafa tabanı
açılarında değişkenliğin olup olmadığının belirlenmesi amaçlandı.

Gereç ve Yöntem: 18-50 yaş aralığında 65 migren
tanılı ve 65 kontrol grubu olmak üzere toplam 130 manyetik rezonans görüntüleri
retrospektif olarak incelendi. Migren ve kontrol grubu arasında modifiye bazal
açı, klivo-aksiyal açı manyetik rezonans görüntülerde tek radyolog tarafından
ölçüldü. Gruplar arasında karşılaştırmada bağımsız t testi kullanıldı. P
<0.05 istatiksel olarak anlamlı olarak kabul edildi.  Ayrıca baziler invajinasyon (McGregor ve
Chamberline hattına göre) açısından değerlendirme yapıldı.

Bulgular: Migren grubu 13 erkek, 52 kadındı
(yaş ortalaması erkek 30.38±11.5, kadın 32.54±9 yıl). Kontrol grubu 15 erkek, 50
kadındı (yaş ortalaması erkek 34.4±8.6, kadın 33.14±9.7 yıl). Migren grubunda; modifiye
bazal açı ortalaması 123.78±6.06°, klivo-aksiyal
açı ortalaması 142.65±8.73°’idi. Kontrol
grubunda; modifiye bazal açı ortalaması 121.6±5.5°,
klivo-aksiyal açı ortalaması 153.66±6.35°’idi.
Gruplar arasında anlamlı farklılık saptandı (p <0,05). Her iki grup için
cinsiyetler arasında farklılık saptanmadı. Ayrıca migren grubunda; 3 hastada McGregor
hattına göre ve 2 hastada McGregor ve Chamberline hattına göre baziler invajinasyon
izlendi. Kontrol grubunda baziler invajinasyon saptanmadı.







Sonuç: Migren hastalarında, manyetik
rezonans görüntülerine göre kafa tabanı açılarında (modifiye bazal açı ve klivo-aksiyal
açı) değişiklikler görülmektedir.

Kaynakça

  • 1. Yücel Y. Migren baş ağrısında tanı ve tedavi yaklaşımları. Dicle Tıp Derg. 2008; 35: 281-6.
  • 2. Palm-Meinders IH, Koppen H, Terwindt GM, et al. Structural brain changes in migraine. JAMA 2012; 14; 308: 1889-97. doi: 10.1001/jama.2012.14276.
  • 3. Pinter NK, McVige J, Mechtler L. Basilar invagination, basilar Impression and platybasia: clinical and imaging aspects. Curr Pain Headache Rep 2016; 20: 49. doi: 10.1007/s11916-016-0580-x.
  • 4.Headache classification subcommittee of the International Headache Society. The international classification of headache disorders. Cephalalgia 3rd edition (beta version). 2013; 33: 629–808. doi: 10.1177/0333102413485658.
  • 5. Hirunpat S, Wimolsiri N and Sanghan N. Normal value of skull base angle using the modified magnetic resonance ımaging technique in Thai population. J Oral Health Craniofac Sci 2017; 2: 17-21.
  • 6. Martin JE, Bookland M, Moote D, Cebulla C. Standardized method for the measurement of Grabb's line and clival-canal angle. J Neurosurg Pediatr 2017; 20: 352-6. doi: 10.3171/2017.5.PEDS17181.
  • 7. Xu S, Gong R. Clivodens angle: A new diagnostic method for basilar Invagination at computed tomography. Spine (Phila Pa 1976) 2016; 41: 1365-71.
  • 8. Ferreira JA and Botelho RV. The odontoid process invagination in normal subjects, Chiari malformation and basilar invagination patients: pathophysiologic correlations with angular craniometry. Surg Neurol Int 2015; 6: 118. doi: 10.4103/2152-7806.160322.
  • 9. Ertas M, Baykan B, Orhan EK, et al. One-year prevalence and the impact of migraine and tension-type headache in Turkey: a nationwide home-based study in adults. J Headache Pain 2012; 13: 147–57. doi: 10.1007/s10194-011-0414-5.
  • 10. Flanagan MF. The Role of the Craniocervical junction in craniospinal hydrodynamics and neurodegenerative conditions. Neurol Res Int 2015; 2015: 794829. doi: 10.1155/2015/794829.
  • 11.Menezes AH. Craniovertebral junction database analysis: incidence, classification, presentation, and treatment algorithms. Childs Nerv Syst. 2008; 24: 1101-8. doi: 10.1007/s00381-008-0605-9.
  • 12. Henderson FC Sr, Henderson FC Jr, Wilson WA IV, Mark AS, Koby M. Utility of the clivo-axial angle in assessing brainstem deformity: pilot study and literature review. Neurosurg Rev 2018; 41: 149-63. doi: 10.1007/s10143-017-0830-3.
  • 13.Vieira DS, Masruha MR, Gonçalves AL et al. Idiopathic intracranial hypertension with and without papilloedema in a consecutive series of patients with chronic migraine. Cephalalgia 2008; 28: 609-13. doi: 10.1111/j.1468-2982.2008.01564.x. 14. Koerte IK, Schankin CJ, Immler S, et al. Altered cerebrovenous drainage in patients with migraine as assessed by phasecontrast magnetic resonance imaging. Invest Radiol 2011; 46: 434-40. doi: 10.1097/RLI.0b013e318210ecf5.
  • 15. Flanagan MF. Migraines, strokes and chiropractic. Dynamic Chiropractic 2002; 20: 21.
  • 16. Kruit MC, Van Buchem MA, Hofman PA, et al. Migraine as a risk factor for subclinical brain lesions. The Journal of the American Medical Assoc 2004; 291: 427–34.
  • 17. Koenigsberg RA, Vakil N, Hong TA, et al. Evaluation of platybasia with MR imaging. AJNR Am J Neuroradio. 2005; 26: 89-92.
  • 18. Botelho RV, Ferreira ED. Angular craniometry in craniocervical junction malformation. Neurosurg Rev 2013; 36: 603- 10. doi: 10.1007/s10143-013-0471-0.
  • 19. Pappas CT, Harrington T, Sonntag VK. Outcome analysis in 654 surgically treated lumbar disc herniations. Neurosurgery 1992; 30: 862–6.
  • 20. Reid CS, Pyeritz RE, Kopits SE, et al. Cervicomedullary compression in young patients with achondroplasia: value of comprehensive neurologic and respiratory evaluation. J Pediatr 1987; 110: 522–30.
  • 21.Nagashima C, Kubota S. Craniocervical abnormalities. Modern diagnosis and a comprehensive surgical approach. Neurosurg Rev 1983; 6: 187–97.
  • 22. Smith JS, Shaffrey CI, Abel MF, Menezes AH. Basilar invagination. Neurosurgery. 2010; 66: 39–47. doi: 10.1227/01.NEU.0000365770.10690.6F.
  • 23.Smoker WR. Craniovertebral junction- normal anatomy, craniometry and congenital anomalies. Radiographics 1994;14: 255–77.
  • 24. Ross JS. Specialty imaging: craniovertebral junction. Lippincott Williams & Wilkins;2013

Is there a relationship between migraine disease and the skull base angles?

Yıl 2018, Cilt: 10 Sayı: 4, 456 - 470, 01.12.2018
https://doi.org/10.21601/ortadogutipdergisi.411138

Öz

Aim: The
aim of the study was to determine whether there were variability in the skull
base according to magnetic resonance images in migraine patients.

Material
and Method:
A total of 130 magnetic resonans images,
including 65 migraine and 65 control groups were retrospectively in the age
range 18-50 years.
Modified basal angle (MBA), clivo-axial angle in
migraine and control groups were measured by a radiologist in
magnetic resonans images. The
independent t test was used to compare between the groups. The level of
significance was set at p < 0.05. In addition, basilar invagination
(according to McGregor and Chamberlain line) was evaluated.

Results: The
m
igraine group was 13 male, 52 female (mean age of
male 30.38±11.5, mean age of female 32.54±9 years). The
control group was 15 males, 50 females (mean age of male
34.4 ±8.6, mean age of female 33.14±9.7 years). In the migraine group; the
modified basal angle average was 123.78 ± 6.06
° and the clivo-axial angle average was 142.65 ±
8.73
°. In
the control group; the modified basal angle average was 121.6 ± 5.5
° and
the clivo-axial angle average was 153.66 ± 6.35
°. Significant differences were detected between
the groups. There was no difference between the genders for
both groups. In the migraine group; according to McGregor line in 3
patients and McGregor and
Chamberlain line in 2 patients, basilar invagination
was observed. Basilar invagination was not detected in the
control group.   







Conclusion: Changes
in the skull base angles (modified basal angle and clivo-axial angle) are
observed in migraine patients

according to magnetic resonance
images.

Kaynakça

  • 1. Yücel Y. Migren baş ağrısında tanı ve tedavi yaklaşımları. Dicle Tıp Derg. 2008; 35: 281-6.
  • 2. Palm-Meinders IH, Koppen H, Terwindt GM, et al. Structural brain changes in migraine. JAMA 2012; 14; 308: 1889-97. doi: 10.1001/jama.2012.14276.
  • 3. Pinter NK, McVige J, Mechtler L. Basilar invagination, basilar Impression and platybasia: clinical and imaging aspects. Curr Pain Headache Rep 2016; 20: 49. doi: 10.1007/s11916-016-0580-x.
  • 4.Headache classification subcommittee of the International Headache Society. The international classification of headache disorders. Cephalalgia 3rd edition (beta version). 2013; 33: 629–808. doi: 10.1177/0333102413485658.
  • 5. Hirunpat S, Wimolsiri N and Sanghan N. Normal value of skull base angle using the modified magnetic resonance ımaging technique in Thai population. J Oral Health Craniofac Sci 2017; 2: 17-21.
  • 6. Martin JE, Bookland M, Moote D, Cebulla C. Standardized method for the measurement of Grabb's line and clival-canal angle. J Neurosurg Pediatr 2017; 20: 352-6. doi: 10.3171/2017.5.PEDS17181.
  • 7. Xu S, Gong R. Clivodens angle: A new diagnostic method for basilar Invagination at computed tomography. Spine (Phila Pa 1976) 2016; 41: 1365-71.
  • 8. Ferreira JA and Botelho RV. The odontoid process invagination in normal subjects, Chiari malformation and basilar invagination patients: pathophysiologic correlations with angular craniometry. Surg Neurol Int 2015; 6: 118. doi: 10.4103/2152-7806.160322.
  • 9. Ertas M, Baykan B, Orhan EK, et al. One-year prevalence and the impact of migraine and tension-type headache in Turkey: a nationwide home-based study in adults. J Headache Pain 2012; 13: 147–57. doi: 10.1007/s10194-011-0414-5.
  • 10. Flanagan MF. The Role of the Craniocervical junction in craniospinal hydrodynamics and neurodegenerative conditions. Neurol Res Int 2015; 2015: 794829. doi: 10.1155/2015/794829.
  • 11.Menezes AH. Craniovertebral junction database analysis: incidence, classification, presentation, and treatment algorithms. Childs Nerv Syst. 2008; 24: 1101-8. doi: 10.1007/s00381-008-0605-9.
  • 12. Henderson FC Sr, Henderson FC Jr, Wilson WA IV, Mark AS, Koby M. Utility of the clivo-axial angle in assessing brainstem deformity: pilot study and literature review. Neurosurg Rev 2018; 41: 149-63. doi: 10.1007/s10143-017-0830-3.
  • 13.Vieira DS, Masruha MR, Gonçalves AL et al. Idiopathic intracranial hypertension with and without papilloedema in a consecutive series of patients with chronic migraine. Cephalalgia 2008; 28: 609-13. doi: 10.1111/j.1468-2982.2008.01564.x. 14. Koerte IK, Schankin CJ, Immler S, et al. Altered cerebrovenous drainage in patients with migraine as assessed by phasecontrast magnetic resonance imaging. Invest Radiol 2011; 46: 434-40. doi: 10.1097/RLI.0b013e318210ecf5.
  • 15. Flanagan MF. Migraines, strokes and chiropractic. Dynamic Chiropractic 2002; 20: 21.
  • 16. Kruit MC, Van Buchem MA, Hofman PA, et al. Migraine as a risk factor for subclinical brain lesions. The Journal of the American Medical Assoc 2004; 291: 427–34.
  • 17. Koenigsberg RA, Vakil N, Hong TA, et al. Evaluation of platybasia with MR imaging. AJNR Am J Neuroradio. 2005; 26: 89-92.
  • 18. Botelho RV, Ferreira ED. Angular craniometry in craniocervical junction malformation. Neurosurg Rev 2013; 36: 603- 10. doi: 10.1007/s10143-013-0471-0.
  • 19. Pappas CT, Harrington T, Sonntag VK. Outcome analysis in 654 surgically treated lumbar disc herniations. Neurosurgery 1992; 30: 862–6.
  • 20. Reid CS, Pyeritz RE, Kopits SE, et al. Cervicomedullary compression in young patients with achondroplasia: value of comprehensive neurologic and respiratory evaluation. J Pediatr 1987; 110: 522–30.
  • 21.Nagashima C, Kubota S. Craniocervical abnormalities. Modern diagnosis and a comprehensive surgical approach. Neurosurg Rev 1983; 6: 187–97.
  • 22. Smith JS, Shaffrey CI, Abel MF, Menezes AH. Basilar invagination. Neurosurgery. 2010; 66: 39–47. doi: 10.1227/01.NEU.0000365770.10690.6F.
  • 23.Smoker WR. Craniovertebral junction- normal anatomy, craniometry and congenital anomalies. Radiographics 1994;14: 255–77.
  • 24. Ross JS. Specialty imaging: craniovertebral junction. Lippincott Williams & Wilkins;2013
Toplam 23 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm Araştırma makaleleri
Yazarlar

Neşe Asal

Mehmet Hamdi Şahan

Yayımlanma Tarihi 1 Aralık 2018
Yayımlandığı Sayı Yıl 2018 Cilt: 10 Sayı: 4

Kaynak Göster

Vancouver Asal N, Şahan MH. Is there a relationship between migraine disease and the skull base angles?. otd. 2018;10(4):456-70.

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