Clinical Characteristics Analysis of Vestibular Migraine Combined With Unruptured Intracranial Aneurysm

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ABSTRACT Background Patients with vestibular migraine (VM) and those with migraine accompanied by unruptured intracranial aneurysm (UIA) may face an increased risk of UIA rupture. This study investigated the rupture risk of UIA in patients with VM and proposed a plausible explanation for the associations between VM, migraine, and UIA distribution, particularly concerning interactions within vascular and nociceptive conduction pathways. Methods A cross‐sectional case‐control study involving 148 subjects diagnosed with UIA was conducted, who were categorized into three groups: the VM, the migraine, and the control groups. The distribution of parent arteries and the morphological parameters of the UIA, such as diameter, size, depth, neck width, mean parent arterial diameter, size ratio, non‐spherical index (NSI), and parameters specific to bifurcation UIA, were extracted from the original imaging data and 3D‐Slicer software for intergroup comparison. Results UIA was predominantly located in the internal carotid arteries (ICA) at C4 (12.3%), C5 (14.0%), and C7 (35.1%) in the VM group. The migraine group exhibited UIA primarily in the ICA at C6 (42.2%) and the vertebrobasilar artery (10.9%). In the control group, UIA was concentrated in the middle cerebral artery (22.6%). These distributions differed significantly ( p 1 = 0.002, p 3 = 0.017). Furthermore, a statistically significant difference was observed in the NSI between the VM and migraine groups ( p = 0.044). Conclusions We observed significant differences in the distribution of UIA between the VM and migraine groups compared to the control group. Furthermore, intergroup comparisons of morphological parameters indicated that both VM and migraine patients have a higher risk of aneurysm rupture. We propose a plausible hypothesis regarding the relationship between VM, migraine, and UIA distribution. Future research should involve more precise hemodynamic analyses, long‐term patient follow‐up, and potential animal studies.

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