Resumen
La migraña es un trastorno neurológico muy común; que afecta al 14,2 por ciento de las mujeres colombianas y al 5,0 por ciento de los colombianos. La Clasificación Internacional de las Cefaleas, Segunda Edición del 2004, agrupa a las cefaleas en primarias y secundarias. La migraña está incluida en una de las cuatro categorías de cefaleas primarias, otras son: la cefalea tipo-tensión, la cefalea en racimos y las otras cefaleas autónomas trigeminales. En esta edición se reestructuraron los criterios para migraña con aura, se introdujo la migraña crónica, y la “migraña” oftalmopléjica ahora es contemplada como una neuralgia craneal.
Hay evidencias de que la migraña es un trastorno genético complejo. Se han descrito dos genes distintos asociados con la migraña hemipléjica familiar, un raro trastorno autosómico dominante.
La migraña es considerada un factor de riesgo de enfermedad vascular cerebral porque las dos entidades comparten algunos mecanismos fisiopatogénicos como los cambios regionales en el flujo sanguíneo cerebral, las alteraciones endoteliales, y la hiperagregabilidad plaquetaria. La utilización cada vez más frecuente del ecocardiograma transesofágico ha hecho posible enfocar la atención en algunas anormalidades cardiacas: foramen oval permeable, aneurisma septal y los eventos vasculares cerebrales isquémicos. Actualmente hay una gran controversia sobre el manejo de estos hallazgos. Es necesario esperar los resultados de estudios bien diseñados para encontrar la relación entre las características clínicas de la migraña y la permeabilidad o el cierre de los defectos septales.
Citas
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