Age-specific association of migraine with cryptogenic TIA and stroke

Abstract

Objective: To determine whether there is an association between previous migraine and cryptogenic TIA or ischemic stroke at older ages. Methods:We determined the age-specific associations of history of migraine and Trial of Org 10172 in Acute Stroke Treatment (TOAST) subtype of TIA and ischemic stroke in a population-based cohort study (Oxford Vascular Study;2002 Conclusions: In this population-based study of stroke etiology stratified by age, migraine was most strongly associated with cryptogenic TIA and ischemic stroke, particularly at older ages, suggesting a causal role or a shared etiology. In contrast to myocardial infarction and peripheral vascular disease, up to one-third of TIA and ischemic strokes are cryptogenic despite detailed diagnostic workup, resulting in roughly 400,000 cases annually in Western Europe alone.1 Moreover, although absolute recurrence rates after cryptogenic TIA or ischemic stroke vary between studies, the prognosis is similar to that of large artery and cardioembolic strokes.2 Better understanding of the pathogenesis of cryptogenic TIA and ischemic stroke is therefore important.Although patent foramen ovale (PFO)-related paradoxical embolism and underdiagnosed paroxysmal atrial fibrillation have been proposed as causes of some cryptogenic TIA and strokes, 3-5 fewer than half of cases can be clearly attributed to these etiologies, 6-9 and so other risk factors (RFs) must be important. Migraine has been shown to be associated with a 2-fold increased risk of ischemic stroke in case-control and cohort studies, 10,11 but only 2 conflicting case-control studies of young stroke looked specifically at cryptogenic events. 12,13 Given that the majority of cryptogenic TIA or strokes occur at older ages, we aimed to study the associations of previous migraine and cryptogenic TIA or ischemic stroke in a population-based cohort study of all TIA and stroke irrespective of age.

The Bucket Test Differentiates Patients with MRI Confirmed Brainstem/Cerebellar Lesions from Patients Having Migraine and Dizziness Alone

“…VM is supposed to be recurrent (i.e., episodic vestibular syndrome), different from CVD that presents as a monophasic prolonged vertigo (i.e., acute vestibular syndrome). Nonetheless, vertebrobasilar TIA can cause recurrent bouts of dizziness, which may be confused with VM symptoms [15]. In addition, duration of VM episodes are notoriously variable, where intense episodes may occur on the order of minutes to hours to days [9], or as constant and lingering symptoms of less intensity but lasting months or years [16].…”

Патогенез Транзиторных Ишемических Атак: Проблема Подтипов

“…Проте розподіл ТІА за таким принципом в іноземних публікаціях згадується лише мимохідь [54][55][56] і практично не використовується в клінічній практиці лікарів-неврологів. У вітчизняній літературі також обґрунтовано не виділені підтипи ТІА, не висвітлені особливості клінічного перебігу та їх на-слідки залежно від провідного патогенетичного підтипу.…”

Migraine Headache: Updates and Future Developments

“…For instance, migraine has a strong association with cryptogenic transient ischemic attack and ischemic stroke, which was found to be highest in older patients without vascular risk factors in a populationbased study of 1800 patients. 10 Further research is needed to clarify the pathophysiological relationship between migraine and other vascular abnormalities.…”