Lightning strike, headache, instant explosion! Yang Rong team: MRI to find out the characteristics of brain lesions.

I've heard of migraine and tension headache, but lightning headache should not be familiar to you. This sudden outbreak of severe headache is worrying that it will lead to complications such as ischemic stroke, cerebral hemorrhage or brain edema. Now, through the new technology of magnetic resonance imaging, we can find the potential brain pathological features of lightning headache, and then provide doctors with a relaxed interpretation, and help to find the physiological mechanism of the disease in the future, as well as new treatment and prevention methods.

Headache caused by lightning stroke is a sudden and explosive headache, which makes people worry that it will lead to complications such as ischemic stroke, cerebral hemorrhage or brain edema. Lightning strike, headache, instant explosion! It is one of the most serious and dangerous headaches.

Reversible Cerebrovascular Contraction Syndrome (RCVS), also known as lightning headache, is one of the most serious and dangerous headache diseases, and its main clinical manifestation is recurrent explosive severe headache with vasoconstriction. During the onset of disease, patients are often induced by defecation, shower, sexual intercourse or emotional excitement, for example. What is even more worrying is that patients have a high probability of complications such as ischemic stroke, cerebral hemorrhage or brain edema, which has caused considerable burden to patients and medical system.

In order to find out the physiological mechanism of lightning headache, Yang Rong Headache Team's Associate Professor Chen Shibin, Associate Professor Zhou Kunxian and Director Wang Shujun, with the help of the special research plan of brain science of the Ministry of Science and Technology, used advanced magnetic resonance neuroimaging technology to find out the specific changes of brain images and clarify the physiological mechanism of lightning headache. This paper was published in JAMA Neurology (if =11.43,5/197).

Large-scale studies in the past have shown that if a few white spots (i.e., white matter high-brightness lesions) appear on the magnetic resonance imaging images of normal people's brains, the risk of stroke, dementia and death in the future will be significantly increased. On the magnetic resonance imaging (MRI) of patients with lightning stroke headache, similar white spots can often be seen, which is highly concerned by doctors and patients. However, there has been no research in the past, which leads to the neglect of the spatial distribution, temporal change and clinical importance of these white matter lesions in the medical field.

(From left): Director, Director Zhuang of the Biology Department of the Ministry of Science and Technology, and Associate Research Fellow Zhou Kunxian of the Brain Science Center of Yangming University. (Photo courtesy of Yang Rong team) The research of Yang Rong team found that the onset cycle of leukoplakia in patients with lightning stroke headache is much higher than that of normal people 10 times.

However, Yang Rong Headache Research Group used the new magnetic resonance imaging sequence and developed a new image analysis technology, which confirmed that the volume of white spots in the brain of patients with lightning stroke headache was much higher than that of normal people 10 times, and these white spots had special spatial distribution and time evolution, which were completely different from white matter lesions related to diseases such as hypertension, diabetes, nephropathy or migraine, and had disease-specific manifestations. Its volume is related to the severity of vascular contraction in the acute stage of the disease, which can be used as the brain index of the severity of the disease. This new technique does not require invasive angiography and can be easily interpreted by ordinary clinicians.

Based on the analysis of hemodynamics, the research team concluded that this white matter lesion is obviously related to excessive cerebral blood flow pulses caused by cerebral ischemia and abnormal autonomic nervous function, which is helpful to develop disease-specific treatment in the future.

At present, the team has conducted more in-depth research and discussion. Recently, the official magazine of the European Headache Union, Journal of Headache and Pain, published a new high-resolution angiography, which interpreted the results of vascular wall inflammation of this disease. It has been confirmed that weather factors including temperature, air pressure and rainfall have an impact on the incidence of the disease of about 10%. The study has been published in Headache, the official journal of the American Headache Association. At present, research on blood, urine, cerebrospinal fluid and genes is being carried out to find possible biomarkers of the disease, hoping to clarify the physiological mechanism of the disease as soon as possible and find new treatment and prevention methods to avoid patients suffering from the disease.