Tesis

Karakteristik Migren Pada Pasien Dengan Dan Tanpa Right to Left Shunt yang di diagnosis dengan Trancranial Doppler Bubble Kontras = Characteristics of Migraine in Patients With and Without Right to Left Shunt Diagnosed Using Transcranial Doppler Bubble Contrast.

Latar Belakang: Migrain merupakan jenis nyeri kepala primer yang sering dikaitkan dengan Right to Left Shunt (RLS). Hubungan antara migrain dan RLS terutama dalam kaitannya dengan mekanisme neurovaskular yang dapat meningkatkan risiko hipoperfusi otak, Cortical Spreading Depression (CSD), serta emboli paradoksal. Namun, karakteristik migrain pada pasien dengan RLS masih belum sepenuhnya dipahami, terutama dalam populasi Indonesia. Metode: Penelitian ini merupakan studi rancagan potong lintang. Subjek penelitian adalah pasien migren yang menjalani pemeriksaan TCD Bubble Contrast dari tahun 2020 – 2024. Data yang diambil berupa karakteristik migren yaitu intensitas, durasi, frekuensi, derajat keparahan, dan tipe migren Hasil: Terdapat 92 pasien menjalani pemeriksaan TCD bubble kontas, dengan 32 pasien RLS positif dan 33 Pasien RLS negatif mengalami Migren. Prevelensi migren pada pasien RLS 72% dengan karakteristik berupa migren dengan aura (p. 0.04), migren kronis (p. 0.02), gejala penyerta yang berbeda bermakna berupa naursea (p : 0.03), Median frekuensi migren dalam sebulan 12 (1 -30) (p.0.03), durasi rata- rata 14 jam (±13)(p.0.07), 34.4% pasien RLS memiliki aura visual (p.0.04), 83% pasien RLS memiliki derajat MIDAS III (p.0.01). Kesimpulan: Prevalensi Migren pada pasien RLS adalah 72 % dengan karakteristik berupa migren dengan aura yaitu aura visual, migren kronis dengan derajat keparahan MIDAS III-IV
Kata kunci: Right to Left shunt, Migren, Karakteristik


Background: Migraine is a primary headache disorder frequently associated with Right to Left Shunt (RLS). The relationship between migraine and RLS has been extensively studied, particularly regarding its neurovascular mechanisms, which may increase the risk of cortical spreading depression (CSD), cerebral hypoperfusion, and paradoxical embolism. However, the characteristics of migraine in patients with RLS remain incompletely understood, particularly in the Indonesian population. Methods: This study is an descriptive study with a cross-sectional design. The subjects were patients who underwent TCD Bubble Contrast examinations between 2020 and 2024. Data collected included migraine characteristics, prevalence, and associated clinical features. Results: A total of 92 patients underwent TCD Bubble Contrast examinations, with 32 patients diagnosed with RLS and 33 RLS-negative patients experiencing migraines. The prevalence of migraine among RLS patients was 72%, with the following significant characteristics Migraine with aura (p = 0.04), Chronic migraine (p = 0.02), Significantly associated symptoms such as nausea (p = 0.03), Median migraine frequency per month: 12 episodes (range 1 –30) (p = 0.03), Average duration: 14 hours (±13) (p = 0.07), 34.4% of RLS patients experienced visual aura (p = 0.04), 83% of RLS patients had MIDAS grade III severity (p = 0.01). Conclusion: The prevalence of migraine in RLS patients is 72%, characterized predominantly by migraine with aura (visual aura), chronic migraine, and severe disability (MIDAS grade III-IV).
Keywords: Right to Left Shunt, Migraine, Characteristics