Didkova Y. Clinical-neurophysiological, neuroimaging and hemodynamic characteristics of migraine complications (status migrainosus and migraine-induced stroke)

In the dissertation on the basis of neurological, hemodynamic, nephysiological and neuroimaging examinations of patients we have determined features of the clinical course of complicated forms of migraine: status migrainosus and migraine-induced stroke. Among the examined patients with complicated forms of migraine, a high level of headache intensity was diagnosed on the VAS scale and a marked loss of social adaptation on the MIDAS scale. During the course of the work, it was found that regardless of the type of migraine complicated by migraine status, the state of hemodynamics in the basin of the middle cerebral arteries and in the basilar artery significantly differs from those in the control group, indicating the failure of their compensation in the period between the attacks. On the basis of data of neuroimaging examinations, characteristic formation of signs of atrophic process and minor nodal zones of gliosis and formation of chronic disresorptive hydrocephaly were revealed. During the study for the first time the correlation between the revealed changes in hemodynamic parameters in the period between attacks of migraine pain, focal changes of the brain substance and the presence of transient neurological symptoms during migraine status is shown. In the case of an EEG mapping analysis in patients with migraine status, desynchronization was detected in the theta range, which intensified after rhythmic photostimulation and the predominance of the proportion of interhemisphere correlations in the alpha range. The revealed changes may indicate a violation of the relationship between the cerebral cortex and thalamic-limbic structures. In the work, the clinical picture was first described, neuroimaging and hemodynamic changes were detected in patients with migraine-induced stroke. Our study showed that the use of sodium solution of valproate in the treatment of status migrainosus in patients with different forms of migraine is statistically significantly and lead to reducing the degree of disability and daily activity during 6 - 8 months after treatment.