Association of migraine headaches with anatomical variations of the Circle of Willis: Evidence from a meta-analysis

Henry, Brandon Michael; Roy, Joyeeta; Ramakrishnan, Piravin Kumar; Vikse, Jens; Tomaszewski, Krzysztof A.; Walocha, Jerzy

doi:10.1016/j.pjnns.2015.06.002

Cited by 18 publications

(14 citation statements)

References 10 publications

(23 reference statements)

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“…Several studies have reported an increased prevalence of CoW variants in people with migraine in comparison to the controls, in particular in migraineurs with aura and in the posterior circulation (Bugnicourt et al., ; Cavestro et al., ; Cucchiara et al., ; Henry et al., ). However, in most studies, the frequency of CoW variants in the control group was less than 50% which is considerably lower than expected from population based studies (El‐Barhoun, Gledhill, & Pitman, ; Kapoor, Singh, & Dewan, ; Krabbe‐Hartkamp et al., ; Li et al., ; Riggs & Rupp, ) and the 85% we found (Table ).…”

Section: Discussionmentioning

confidence: 99%

“…CoW variants may be congenital but can also be acquired when patients get older (Zaninovich, Ramey, Walter, & Dumont, 2017). Some (Bugnicourt et al, 2009;Cavestro et al, 2011;Cucchiara et al, 2013;Henry et al, 2015), but not all (Schoonman, van Oosterhout, Ferrari, & van der Grond, 2010;Ezzatian-Ahar et al, 2014;Ikeda et al, 2017), studies report a higher frequency of incomplete CoW in migraine patients compared with controls in particular for the posterior circulation and in patients with migraine with aura.…”

Section: Introductionmentioning

confidence: 99%

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Circle of Willis variations in migraine patients with ischemic stroke

et al. 2019

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Objectives Migraine is a risk factor for stroke, which might be explained by a higher prevalence in anatomical variants in the circle of Willis (CoW). Here, we compared the presence of CoW variants in patients with stroke with and without migraine. Materials and Methods Participants were recruited from the prospective Dutch acute Stroke Study. All participants underwent CT angiography on admission. Lifetime migraine history was assessed with a screening questionnaire and confirmed by an interview based on International Classification of Headache Disorders criteria. The CoW was assessed for incompleteness/hypoplasia (any segment <1 mm), for anterior cerebral artery asymmetry (difference > 1/3), and for posterior communicating artery (Pcom) dominance (Pcom–P1 difference > 1/3). Odds ratios with adjustments for age and sex ( aOR ) were calculated with logistic regression. Results We included 646 participants with stroke, of whom 52 had a history of migraine. Of these, 45 (87%) had an incomplete or hypoplastic CoW versus 506 (85%) of the 594 participants without migraine ( aOR : 1.47; 95% CI : 0.63–3.44). There were no differences between participants with and without migraine in variations of the anterior or posterior CoW, anterior cerebral artery asymmetry ( aOR : 0.86; 95% CI : 0.43–1.74), or Pcom dominance ( aOR : 0.64; 95% CI : 0.32–1.30). There were no differences in CoW variations between migraine patients with or without aura. Conclusion We found no significant difference in the completeness of the CoW in acute stroke patients with migraine compared to those without.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Circle of Willis variations in migraine patients with ischemic stroke

et al. 2019

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“…Items for the AQUA Tool were generated on the basis of (1) the extensive background of the steering committee in conceiving and executing anatomical metaanalyses and systematic reviews, and (2) a review of the anatomical literature (Andall et al, 2015;Henry et al, 2015aHenry et al, , 2015bRamakrishnan et al, 2015;Roy et al, 2015;Tomaszewski et al, 2016aTomaszewski et al, , 2016bTomaszewski et al, , 2016cTomaszewski et al, , 2016dVikse et al, 2016). No comprehensive systematic review of systematic reviews was performed because there was no previously-used quality assessment of anatomical studies, and the number of true evidence-based reviews and meta-analyses in the literature is limited.…”

Section: Preliminary Conceptual Design and Item Generationmentioning

confidence: 99%

Development of the Anatomical Quality Assessment (AQUA) Tool for the quality assessment of anatomical studies included in meta‐analyses and systematic reviews

Henry¹,

Tomaszewski²,

et al. 2016

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Critical appraisal of anatomical studies is essential before the evidence from them undergoes meta-epidemiological synthesis. However, no instrument for appraising anatomical studies with inherent applicability to different study designs is available. We aim to develop a generic yet comprehensive tool for assessing the quality of anatomical studies using a formal consensus method. The study steering committee formulated an initial conceptual design and generated items for a preliminary tool on the basis of a literature review and expert opinion. A Delphi procedure was then adopted to assess the validity of the preliminary tool. Feedback from the Delphi panelists was used to improve it. The Delphi procedure involved 12 experts in anatomical research. It comprised two rounds, after which unanimous consensus was reached about the items to be included. The preliminary tool consisted of 20 items, which were phrased as signaling questions and organized into five domains: 1. Aim and subject characteristics, 2. Study design, 3. Characterization of methods, 4. Descriptive anatomy, and 5. Results reporting. Each domain was set to end with a risk of bias question. Following round 1, some of the items underwent major revision, although agreement was reached regarding inclusion of all the domains and signaling questions in the preliminary tool. The tool was revised only for minor language inaccuracies after round 2. The AQUA Tool was designed to assess the quality and reliability of anatomical studies. It is currently undergoing a validation process. Clin. Anat. 30:6-13,

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“…), and the extensive background of the steering committee in conducting meta-analyses and systematic reviews of anatomical studies (Andall et al, 2015;Henry et al, 2015aHenry et al, , 2015bRamakrishnan et al, 2015;Roy et al, 2015aRoy et al, , 2015bTomaszewski et al, 2016aTomaszewski et al, , 2016bTomaszewski et al, , 2016cTomaszewski et al, , 2016dVikse et al, 2016), we developed a preliminary conceptual design for the AQUA Checklist. In addition to items considered standard in reporting all medical studies (sample size, demographics, results, etc.…”

Section: Preliminary Conceptual Design and Item Generationmentioning

confidence: 99%

“…In that context, the authors of the present study have developed the Anatomical Quality Assurance (AQUA) Checklist, the aim of which is to improve the quality of reporting of anatomical studies. From our extensive experience of evidence-based anatomical studies (Andall et al, 2015;Henry et al, 2015aHenry et al, , 2015bRamakrishnan et al, 2015;Roy et al, 2015aRoy et al, , 2015bTomaszewski et al, 2016aTomaszewski et al, , 2016bTomaszewski et al, , 2016cTomaszewski et al, , 2016dVikse et al, 2016), we have found that such studies are often poorly reported, thus decreasing their reliability and increasing the risk of bias. A high reporting quality is imperative since understanding and knowledge of anatomy allows for successful clinical interventions.…”

Section: Introductionmentioning

confidence: 99%

Development of the Anatomical Quality Assurance (AQUA) Checklist: Guidelines for reporting original anatomical studies

Tomaszewski¹,

Henry²,

Ramakrishnan³

et al. 2016

Clinical Anatomy

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The rise of evidence-based anatomy has emphasized the need for original anatomical studies with high clarity, transparency, and comprehensiveness in reporting. Currently, inconsistencies in the quality and reporting of such studies have placed limits on accurate reliability and impact assessment. Our aim was to develop a checklist of reporting items that should be addressed by authors of original anatomical studies. The study steering committee formulated a preliminary conceptual design and began to generate items on the basis of a literature review and expert opinion. This led to the development of a preliminary checklist. The validity of this checklist was assessed by a Delphi procedure, and feedback from the Delphi panelists, who were experts in the area of anatomical research, was used to improve it. The Delphi procedure involved 12 experts in anatomical research. It comprised two rounds, after which unanimous consensus was reached regarding the items to be included in the checklist. The steering committee agreed to name the checklist AQUA. The preliminary AQUA Checklist consisted of 26 items divided into eight sections. Following round 1, some of the items underwent major revision and three new ones were introduced. The checklist was revised only for minor language inaccuracies after round 2. The final version of the AQUA Checklist consisted of the initial eight sections with a total of 29 items. The steering committee hopes the AQUA Checklist will improve the quality and reporting of anatomical studies. Clin.

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Association of migraine headaches with anatomical variations of the Circle of Willis: Evidence from a meta-analysis

Abstract: Migraine is associated with anatomical variations in both the anterior and posterior portions of the COW. However, larger prospective trials are needed to determine the true prevalence of variations and their pathological significance.

Cited by 18 publications

References 10 publications

Circle of Willis variations in migraine patients with ischemic stroke

Circle of Willis variations in migraine patients with ischemic stroke

Development of the Anatomical Quality Assessment (AQUA) Tool for the quality assessment of anatomical studies included in meta‐analyses and systematic reviews

Development of the Anatomical Quality Assurance (AQUA) Checklist: Guidelines for reporting original anatomical studies

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