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INTRODUCTION: Vestibular migraine (VM) is a prevalent vestibular disorder characterized by episodic vertigo. However, the relationship between photophobia and visual triggers in VM remains unexplored. We investigated the correlation of photophobia during the VM attack with interictal photosensitivity and visually triggering dizziness in patients with VM. METHODS: We enrolled patients diagnosed with VM, with or without photophobia, across seven specialized vertigo and headache clinics in China. Healthy individuals were also included as a control group. Using a cross-sectional survey design, we collected data related to light intensity and dizziness frequency triggered by flicker, glare, and eyestrain using the Headache Triggers Sensitivity and Avoidance Questionnaire. RESULTS: A total of 366 patients were recruited. The photosensitivity and frequency of dizziness induced by flicker, glare, and eyestrain observed in patients with VM and photophobia were significantly elevated compared with those in patients without photophobia and control participants (P < 0.001). A significant positive correlation was observed between photosensitivity levels and dizziness frequency triggered by flicker, glare, and eyestrain in patients with VM and photophobia (P < 0.001). CONCLUSIONS: This study unequivocally established a positive association of ictal photophobia with interictal photosensitivity and visually triggering dizziness, strongly advocating the need for further research on exposure-based therapies for managing VM. CLINICAL TRIALS REGISTRATION: ClinicalTrial.gov Identifier, NCT04939922, retrospectively registered, 14th June 2021.
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INTRODUCTION: To provide updated evidence on the sex-based differences in the risk of mortality and functional outcomes in subjects with intracerebral haemorrhage. METHODS: A systematic search of eligible studies was conducted using three large databases such as PubMed, EMBASE, and Scopus for observational studies that documented the comparative risk of mortality and functional outcomes based on the subjects' sex. Only studies published in the year 2000 and onwards were included. Random effects model was used to pool relevant data and effect sizes were reported as odds ratio (OR) with 95% confidence intervals (CI). RESULTS: The review included 32 studies. In most of the studies, female subjects had a higher mean age compared to males and had a higher rate of neurological deficits at admission. A higher proportion of males had cardiovascular risk factors. The risk of mortality at hospital discharge (OR 0.98, 95% CI: 0.90, 1.06), and one- (OR 0.98, 95% CI: 0.81, 1.18), three- (OR 1.13, 95% CI: 0.95, 1.33) and 12-months (OR 1.04, 95% CI: 0.90, 1.19) follow up was similar in both sexes. Compared to females, males had a lower risk of poor functional outcomes at 3 months (OR 0.83, 95% CI: 0.77, 0.89) and 12 months (OR 0.87, 95% CI: 0.77, 0.98) follow-up. CONCLUSION: There is a similar risk of mortality but better functional outcomes in males with intracerebral haemorrhage compared to females. However, the findings should be interpreted cautiously as there were significant sex-based differences in risk profiles at admission. Further studies that focus on careful and meticulous examination of sex-specific association with survival and functional outcomes are needed.
