Abstract
BackgroundMigraine with aura is associated with patent foramen ovale and right-left-shunt. Jugular venous valve insufficiency is a further vascular anomaly. It is a frequent finding in transient global amnesia which is associated with migraine. Therefore, we investigated the prevalence of jugular venous valve insufficiency in migraine.MethodsSubjects included in this study were participants of the population based German Headache Study on the prevalence of primary headaches. In 36 patients with migraine with aura, 50 patients with migraine without aura and 43 controls without headaches duration of backward venous flow, peak velocity flow and diameters of the jugular venous valves were assessed by color-coded duplex and Doppler sonography and compared between groups. In all migraine patients, examination was performed between and not during migraine attacks. Therefore, 9 additional patients with chronic daily headache were investigated during headache.ResultsWe did not find statistically significant differences in duration of flow, peak velocity flow and diameter of the jugular venous valves in patients with migraine with aura (mean values 0.53 ± 0.43 sec; 35.47 ± 33.87 cm/sec; 8.84 ± 3.17 mm), migraine without aura (0.61 ± 0.63 sec; 33.39 ± 25.80 cm/sec; 8.15 ± 3.02 mm) or controls (0.64 ± 0.51 sec; 35.28 ± 31.76 cm/sec; 8.79 ± 2.97 mm) (group effects p-values >0.41). For all parameters results were the same for the left and the right side of jugular venae (side effects p-values >0.09). Also patients with chronic daily migraine with headache during the examination showed no differences to controls (0.52 ± 0.49 sec; 27.95 ± 21,75 cm/sec; 8.07 ± 2.71 mm) (all p-values > 0.23).ConclusionsThe prevalence of internal jugular venous valve insufficiency is not increased in persons with migraine.
Highlights
Migraine with aura is associated with patent foramen ovale and right-left-shunt
There seems to be an association with migraine with aura and right – left shunts and patent foramen ovale (PFO) [2]
transient global amnesia (TGA) and migraine on the one hand and TGA and jugular venous valve insufficiency (JVVI) on the other hand are independently associated with one another
Summary
Migraine with aura is associated with patent foramen ovale and right-left-shunt. Jugular venous valve insufficiency is a further vascular anomaly. Some authors have suggested that a migraine aura could be caused by desoxygenated blood that reaches cerebral circulation by a right-left shunt [3]. Whether this association is causal or coincidental or if migraine and PFO share a common genetic predisposition is not known. Internal jugular venous valve insufficiency (JVVI) is another vascular anomaly that is a frequent finding in TGA and migraine on the one hand and TGA and JVVI on the other hand are independently associated with one another. Aim of this controlled trial was to investigate whether migraine with or without aura is associated with JVVI using color-coded duplex and Doppler sonography
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