Migraine and risk of perioperative ischemic stroke and hospital readmission: hospital based registry study

Timm, Fanny P.; Houle, Timothy T.; Grabitz, Stephanie D.; Lihn, Anne Louise; Stokholm, J; Eikermann-Haerter, Katharina; Nozari, Ala; Kurth, Tobias; Eikermann, Matthias

doi:10.1136/bmj.i6635

Cited by 55 publications

(45 citation statements)

References 62 publications

(29 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In fact, it is now included as a cardiovascular risk factor in a popular risk stratification tool . Migraine also is associated with an increased risk of ischemic stroke and of perioperative stroke, which is most apparent in otherwise healthy young people …”

Section: What Are the Pharmacologic Options For Prevention And How Dmentioning

confidence: 99%

Pharmacologic Prevention of Migraine: A Narrative Review of the State of the Art in 2018

Loder

Rizzoli

2018

Headache

View full text Add to dashboard Cite

This paper describes current non-antibody pharmacologic approaches to the prevention of migraine in adults. Preventive therapy should be considered for patients with migraine who routinely have more than 6 headache days per month or in other special circumstances. Choices for preventive therapy are based on patient preferences about side effects and evidence of efficacy. The evidence level and commonly used doses for selected categories of migraine preventive medication are reviewed, including antiepileptic drugs, antihypertensive drugs, and antidepressants. Propranolol, timolol, topiramate, and divalproex sodium are approved for migraine prevention by the US FDA. OnabotulinumtoxinA is approved for prevention of chronic migraine. Several off-label drugs, especially lisinopril, candesartan, and amitriptyline also have good evidence of benefit. The spectrum of response to preventive therapy varies; in general, complete cessation of headaches is uncommon, although there are "super-responders" to every therapy, as illustrated by patient reports of dramatic responses to treatment. Preventive treatment should be started at a low dose and doses increased slowly until therapeutic benefit is achieved or side effects preclude continued use.

show abstract

Section: What Are the Pharmacologic Options For Prevention And How Dmentioning

confidence: 99%

Pharmacologic Prevention of Migraine: A Narrative Review of the State of the Art in 2018

Loder

Rizzoli

2018

Headache

View full text Add to dashboard Cite

show abstract

“…9 A cross-sectional US populationbased case-control study used the Nationwide Inpatient Sample (NIS) to examine the association between migraine and stroke during pregnancy and found a strong relationship between active peripartum migraine and vascular diagnoses during pregnancy. Prior studies demonstrating increased readmission rate for cerebrovascular events were limited to surgical and peripartum patients who had co-existing migraine.…”

Section: Discussionmentioning

confidence: 99%

“…In an outpatient setting, ICD-9-CM codes can identify migraine sufferers with a high specificity (86.3-99.2%) but only modest sensitivity. 13 9), intracranial hemorrhage (ICH; 431), and subarachnoid hemorrhage (SAH; 430). 10 We modified the migraine diagnosis code used in the aforementioned study using additional codes of exclusion, aiming to improve our sensitivity.…”

Section: Methodsmentioning

confidence: 99%

“…[3][4][5][6][7] For example, a large, prospective cohort study with over 20 years of follow-up in 115,541 female nurses aged 25-42 with a migraine diagnosis showed a consistent association between migraine and cardiovascular events, including acute ischemic stroke (AIS). 9 Another study found a strong association between active peripartum migraine and AIS. 8 Migraine is most often managed on an outpatient basis.…”

Section: Introductionmentioning

confidence: 98%

See 1 more Smart Citation

Impact of Aura and Status Migrainosus on Readmissions for Vascular Events After Migraine Admission

et al. 2018

View full text Add to dashboard Cite

show abstract

“…This is because increased vulnerability sheds light on another clinical aspect of outstanding interest, namely the ever-increasing epidemiological evidence that the neuronal network anomalies underlying migraine with aura represent a weak but significant risk factor for cerebral injuries (14). This applies even more so to FHM, which can show rare courses up to lifethreatening febrile coma (15) and stroke (16).…”

mentioning

confidence: 99%

Exploitation of the spreading depolarization-induced cytotoxic edema for high-resolution, 3D mapping of its heterogeneous propagation paths

Dreier

Reiffurth

2017

Proc. Natl. Acad. Sci. U.S.A.

View full text Add to dashboard Cite

Spreading depolarization (SD) is among the most archaic pathological phenomena of the central nervous system and already occurs in comparably primitive animals, such as locusts and cockroaches (1). SD describes a regenerative, all-or-none type of depolarization wave in gray matter of the central nervous system characterized by the abrupt, near-complete breakdown of the transneuronal ion gradients. It is assumed that SD is perceived as migraine aura when it invades a perceptual and eloquent brain region, where it induces spreading depression of the normal brain activity. However, SD also occurs in various conditions other than migraine, including stroke and traumatic brain injury (TBI). Although there is unequivocal electrophysiological evidence that SD often induces spreading depression of activity in stroke and TBI, computational dysfunction before SD migration through the tissue usually precludes the patient percept of a migraine aura in these injurious conditions (2). Initiation, recovery, pharmacology, depression patterns, and toxicity may vary dramatically along the propagation path of a single SD wave, dependent on the local conditions of the tissue. However, all SDs-no matter whether they occur in well-nourished, traumatized, or severely ischemic tissue-share the same phenomenology, including the same magnitude of neuronal depolarization and the principal ion changes involved, a similar release of free energy (free-energy starving) and spread in the tissue. SDs also share influx of water into neurons driven by the ionic changes across the cellular membrane. In other words, SD is the principal mechanism of the cytotoxic edema in many gray matter structures of the brain. Using two-photon microscopy, the cytotoxic edema is observed as SD-induced dendritic beading (3). Beaded morphology allows a larger volume to be encompassed within an equivalent surface area. Beading-induced changes in cell membrane morphology are sufficient to significantly hinder intracellular water mobility (4). Using diffusion-weighted MRI (DW-MRI), this translates into a characteristic drop in the apparent diffusion coefficient when SD is moving in the tissue, no matter whether or not the tissue is ischemic (5) (Fig. 1). In PNAS, Cain et al. elegantly exploit this characteristic trait to trace SD's propagation path in the naïve mouse brain in a 3D, whole-brain perspective with high-temporal resolution Fig. 1. SD is associated with near-complete breakdown of the transcellular ion concentration gradients, which causes intracellular hyperosmolality. The resulting water influx into neurons leads to cytotoxic edema, which causes abrupt dendritic beading. Beaded morphology allows a larger volume to be encompassed within an equivalent surface area. In normal neurites, water mobility is highly restricted by the cell membrane perpendicular to the main axis, whereas water molecules diffusing along the main axis of the neurite encounter few barriers on the timescale of DW-MRI measurements. However, undulation of the cell membrane induced by neuri...

show abstract

Migraine and risk of perioperative ischemic stroke and hospital readmission: hospital based registry study

Cited by 55 publications

References 62 publications

Pharmacologic Prevention of Migraine: A Narrative Review of the State of the Art in 2018

Pharmacologic Prevention of Migraine: A Narrative Review of the State of the Art in 2018

Impact of Aura and Status Migrainosus on Readmissions for Vascular Events After Migraine Admission

Exploitation of the spreading depolarization-induced cytotoxic edema for high-resolution, 3D mapping of its heterogeneous propagation paths

Contact Info

Product

Resources

About