Margarita ShumilinaFederal State Budget Institution, Russian Federation
Title: Headaches in vascular path ology. Why can a headache occur with arterial hypertension?
The connection of headache with cardiovascular diseases is underestimated. Mandatory ultrasound examination of brachiocephalic arteries and veins, measurement of venous pressure, comparison with the results of radiation methods, with postoperative observations for 30 years has allowed to identify and systematize a number of objective vascular factors that provoke the occurrence of certain types of headaches. At the heart of headache (outside of cerebral organic pathology) often there are violations of venous outflow with the development of venous encephalopathy, violations of brain perfusion, cerebro-ischemic variant of secondary arterial hypertension. The cause of arteriovenous imbalance may be systemic or regional phlebohypertension with anomalies of brachiocephalic veins (hypoplasia, compression, valve abnormalities, thrombosis), arteriovenous fistulas. Arteriovenous imbalance increases with arterial hypertension and with the activation of inflow after reconstruction of the carotid arteries with the development of hyperperfusion syndrome. Pathology of the cervical spine is accompanied by hypertrophy of the stair and nodding muscles with secondary compression of the jugular veins and a decrease in outflow. Phenotypic and ultrasound signs of elongated transverse processes of the seventh cervical vertebra, often found in pain of occipital and cervical localization, were revealed. Headache can be provoked by anomalies of the styloid process associated with its elongation, curvature, fracture, as well as with ossification of the ligaments attached to it. For the first time, we have developed an ultrasound technique for detecting different forms of Eagle syndrome: stylo-carotid, sublingual-carotid, thyroid-carotid and stylo-jugular with compression of the vein by the styloid process and transverse processes of the C1/C2 vertebrae. Analysis of studies of patients with a simple form of migraine has led to the conclusion that it is caused by cerebral phlebohypertension associated with structural and/or functional disorders of venous outflow.
Margarita Shumilina – Doctor of Medical Sciences, Head of the group of ultrasound studies of cardiovascular and Organ Pathology of the A.N. Bakulev Center for Cardiovascular Surgery. She is a professor at the Department of Cardiology, Functional and Ultrasound Diagnostics with a course in Pediatric Cardiology. She is the author of 283 papers that have been cited 940 times, the Hirsch index is 13. She is the deputy editor-in-chief of the journal "Clinical Physiology of Blood Circulation, a member of the editorial board of the journal "Angiology and Vascular Surgery named after Academician A.V. Pokrovsky".