Background

The etiology of migraine can be complex and multifactorial but not clear, also, intracranial pressure has been already associated with migraine attacks. This study aimed to monitor intracranial pressure during migraine attack to understand the possible relations with disease and severity.

Methods

A prospective randomized study was designed. Patients with a definitive diagnosis of migraine underwent ultrasonography for optic nerve sheath diameter (ONSD) measurement before treatment and were re-measured after the attack was resolved. The severity of the migraine was assessed with Headache Impact Test-6 (HIT-6) and Migraine Disability Assessment (MIDAS) questionnaire before the treatment and after the symptoms regressed. ONSD values and scores from the questionnaires were compared before and after the migraine attack.

Results

The study included 11 (52.4%) women and 10 (47.6%) men, and 42 eyes were evaluated. ONSD was detected as 4.23 ± 0.26 mm in the right eye and 4.10 ± 0.32 mm in the left eye during the migraine attack and decreased to 3.65 ± 0.41 mm in the right eye and 3.50 ± 0.33 mm in the left eye after the attack was treated (p < 0.001, both). A similar statistical improvement was found in HIT-6 and MIDAS scores with ONSD after treatment (p < 0.001). A significant positive correlation was found between the ONSD value in both eyes and HIT-6/MIDAS scores during the migraine attack, and also, after the migraine attack.

Conclusion

A subjective increase of ONSD values during the migraine attack decreased after the disease resolved, also changes in ONSD values were significantly correlated with the severity of symptoms.

中文翻译：

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急性偏头痛发作期间视神经鞘直径的监测：疾病严重程度的客观标准

背景

偏头痛的病因可能是复杂的、多因素的，但尚不清楚，而且颅内压已经与偏头痛发作有关。本研究旨在监测偏头痛发作期间的颅内压，以了解其与疾病和严重程度的可能关系。

方法

设计了一项前瞻性随机研究。明确诊断为偏头痛的患者在治疗前接受超声检查以测量视神经鞘直径（ONSD），并在发作缓解后重新测量。在治疗前和症状消退后，通过头痛影响测试 6 (HIT-6) 和偏头痛残疾评估 (MIDAS) 问卷评估偏头痛的严重程度。比较偏头痛发作前后的 ONSD 值和问卷得分。

结果

该研究包括 11 名（52.4%）女性和 10 名（47.6%）男性，并对 42 只眼睛进行了评估。偏头痛发作期间，右眼 ONSD 检测为 4.23 ± 0.26 毫米，左眼 4.10 ± 0.32 毫米，治疗后右眼 ONSD 降至 3.65 ± 0.41 毫米，左眼 3.50 ± 0.33 毫米（p  < 0.001，两者）。治疗后 ONSD 的 HIT-6 和 MIDAS 评分也有类似的统计改善（p  < 0.001）。在偏头痛发作期间以及偏头痛发作后，双眼ONSD值与HIT-6/MIDAS评分之间发现显着正相关。

结论

偏头痛发作期间 ONSD 值的主观增加在疾病解决后下降，而且 ONSD 值的变化与症状的严重程度显着相关。