ИСТИНА

Background: Migraine is considered to be a risk factor for the CeAD. Aim: to analyze frequency and type of the headaches in the past history of patients survived CeAD and to investigate the carotid artery elasticity in them. Material and methods: Among 180 patients with CeAD verified by MRI/MRA, there were 93 patients with headaches in the past history (62 women, 83%, mean age 38.2 ± 6.9 years). The type of the headache was estimated using the International Headache Society criteria. The comparison group consisted of 27 patients with migraine as a primary disease; normal control group included 49 healthy subjects matched for age and sex. In 22 CeAD patients who had headache in the past history as well as in all individuals of control and comparison groups CAE was studied by ultrasound. Distensibility coefficient (DC), Young's elastic modulus (YEM) and stiffness index (SI) were calculated. Results: Localization of CeAD in 93 patients was as following: internal carotid artery (ICA) - 46 patients (50%), vertebral artery (VA) - 42 patients (45%), the combination of ICA and VA - 5 patients (5%). Headache met the criteria for migraine in 30 out of 93 patients (32%), 32 patients (34%) had migraine-like headache, which was not accompanied by photo-phonophobia, nausea/vomiting. Other patients suffered from periodic, one- or two-sided, easy/moderate in intensity, pressing, dull, squeezing headaches. In contrast to episodic tension headache it was not combined with depression. Ultrasound study showed that in CeAD patients with headache in the past history DC was lower (26.5[19.0; 33.6]), whereas SI (6.1 [4.7; 8.7]) and YEM (51.5 [30.9; 60.1]) - higher than in patients with migraine as a primary disease (DC - 46.2 [37.2; 59.4]; SI – 4.0 [2.9; 5.3]; YEM – 22.4 [16.4; 27.0], respectively, (p<0.001). The parameters of the common carotid artery elasticity in migraine patients and normal control did not differ significantly. Conclusion: Headaches in the past history of CeAD patients meet the criteria for migraine only in one third of the patients. The decrease of CAE in young patients suffering from headaches may be a risk factor for CeAD development. It is assumed that the decreased arterial wall elasticity may play a role in the pathogenesis of the headache which is in the past history of patients with dissection.