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Headache: an important symptom possibly linked to white matter lesions in thalassaemia
Author(s) -
Premawardhena Anuja,
Ranawaka Udaya,
Pilapitiya Taraka,
Weerasinghe Gihan,
Hapangama Aruni,
Hettiarachchi Shantha,
Pathmeswaran Arunasalam,
Salvin Karahinarachichige,
Silva Ishari,
Hameed Nizri,
Weatherall Mark,
Olivieri Nancy,
Weatherall David
Publication year - 2019
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/bjh.15825
Subject(s) - headaches , medicine , magnetic resonance imaging , white matter , thalassemia , hyperintensity , pediatrics , cognitive decline , cognition , surgery , radiology , dementia , psychiatry , disease
Summary Neurological manifestations are reported only occasionally in patients with thalassaemia and are given much less prominence than the complications related to anaemia and iron overload. White matter changes ( WMC s) on magnetic resonance imaging ( MRI ) in patients with thalassaemia were first reported two decades ago but the significance of these lesions remains unclear. We studied the neurological and cognitive manifestations in 82 older patients with thalssaemia [25 Thalassaemia major ( TM ), 24 thalassaemia intermedia ( TI ) and 33 haemaglobin E β thalassaemia ( EBT )] and 80 controls, and found that headaches were more common in thalassaemia patients (50/82, 61%) than in controls (18/80, 22·5%: P < 0·001). WMC s on MRI were found in 20/82 (24·3%) patients and 2/29 (6·9%) controls had ( P = 0·078). WMC were more common among those with headaches (17/50: 34%) than in those without headache (3/32; 9·3%) ( P = 0·023). WMC s were not associated with reduction of cognition. Nevertheless, cognition was lower in the TI and EBT groups compared with those with TM ( P = 0·002). The association of headache with WMC in thalassaemia has not been reported before and warrants further study.