Migraine Headache and Ischemic Stroke Risk: An Updated Meta-analysis

Spector, June T.; Kahn, Susan R.; Jones, Miranda R.; Jayakumar, Monisha; Dalal, Deepan; Nazarian, Saman

doi:10.1016/j.amjmed.2009.12.021

Cited by 361 publications

(338 citation statements)

References 54 publications

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“…The relationship between stroke and migraine is controversial. Available data show an increased relative risk of ischaemic stroke in patients with migraine, especially in patients with migraine and aura (2)(3)(4). However, the underlying pathophysiological mechanisms remain elusive.…”

Section: Introductionmentioning

confidence: 99%

Diffusion-weighted lesions in acute ischaemic stroke patients with migraine

et al. 2014

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Objectives -There is increasing knowledge about an association between migraine and ischaemic stroke. Cortical spreading depression (CSD) is the probable biological substrate of migrainous aura. To investigate the influence of CSD on the apparent stroke -migraine association, we hypothesized that magnetic resonance (MR) diffusion weighted images of acute ischaemic stroke patients would reveal an association between small cortical infarctions and migraine. Methods -We included all patients admitted to the Bergen stroke unit between 2006 and 2012 with verified acute ischaemic stroke by MR imaging. Patients were grouped in a migraine and a no-migraine group. Baseline data and clinical characteristics were analysed between the groups. Imaging data were analysed with respect to infarct location and size. Multivariate analyses were performed to adjust for confounders and provide risk estimates for observed associations. Results -A total of 1703 subjects were enrolled, 787 subjects were excluded due to uncertain or unobtainable migraine diagnosis, leaving 196 and 720 subjects in the migraine and nomigraine group, respectively. The migraine group was younger and included a higher proportion of females. There were more infarctions due to cardio-embolism (P = 0.015) and fewer due to small vessel disease (P = 0.018) in the migraine group. A higher rate of patients in the migraine group presented symptoms from the posterior circulation (P = 0.008). Migraine was associated with cortical infarctions (OR 1.8 CI: 1.3-2.5, P = 0.001). Migraine was also associated with small infarctions (OR 1.9 CI: 1.04-3.5, P = 0.038). Conclusions -Migraine was associated with small cortical infarctions. This association may be due to cortical spreading depression.

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Section: Introductionmentioning

confidence: 99%

Diffusion-weighted lesions in acute ischaemic stroke patients with migraine

et al. 2014

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“…Migraine with aura is a wellestablished risk factor for ischemic stroke (Spector et al 2010). According to the International Headache Society, migrainous infarction is defined as one or more migrainous aura symptoms associated with an ischemic brain lesion in the appropriate territory as demonstrated by neuroimaging.…”

Section: Similarity To Migrainous Infarctionmentioning

confidence: 99%

Stroke and Stroke-Like Symptoms in Patients with Mutations in the POLG1 Gene

et al. 2011

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Introduction/Methods Mutations in POLG1, the gene encoding mitochondrial polymerase gamma (Polg), have been associated with a number of well-characterized phenotypes. In this study, we report two cases of patients with biallelic POLG1 mutations and stroke. We also performed a review of the literature and report on all clinical studies of patients with POLG1 mutations in which stroke was described in the phenotype. For each patient, genotype and phenotype are reported.Results Including our two patients, a total of 22 patients have been reported with POLG1 mutations and stroke. The average age of onset of stroke in these patients was 9 years with a range of 1-23 years. In cases where localization was reported, the occipital lobes were the primary location of the infarct. Mutations in the linker-linker or linker-polymerase domains were the most frequent genotype observed. Seizures (16/22) and hepatic dysfunction/failure (8/22) were the most commonly reported symptoms in the stroke cohort.Conclusion This article raises an underrecognized point that patients with POLG1 mutations may suffer a cerebrovascular accident at a young age. The most common location of the infarction is in the occipital lobe. The presentation may be similar to MELAS and can be misdiagnosed as a migrainous stroke.

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“…Spector с соавт. позже опубликовали метаанализ 21 исследования (13 обсервационных и 8 когортных), в кото-рые было включено 622 380 пациентов [11]. Относи-тельный риск ИИ в этой популяции больных с мигренью по сравнению с лицами без мигрени составил 2,04 с максимальными значениями для мигрени с аурой (ОР = 2,25) по сравнению с мигренью без ауры (ОР = 1,24).…”

Section: риск ишемического инсульта у пациентов с мигреньюunclassified

“…Следует отметить, что при менструально-ассоциированной мигрени стабилизация уровня эстрогенов использованием гормональных контрацептивов может сопровождаться снижением интенсивности и длительности связанных с менструацией приступов мигрени. Между тем эта страте-гия должна быть ограничена у пациентов с мигренью с аурой при высокой частоте приступов из-за высокого риска ИИ [11]. По крайней мере, это использование долж-но быть ограничено применением низкодозных оральных контрацептивов (≤25 мкгр этинил эстрадиола), поскольку риск ИИ при их использовании минимальный [11].…”

Section: модификация стратегий ведения пациентов с мигренью и высокимunclassified

Migraine-Associated Cerebrovascular Disorders

Tabeeva¹

2017

Med. sov.

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Migraine Headache and Ischemic Stroke Risk: An Updated Meta-analysis

Cited by 361 publications

References 54 publications

Diffusion-weighted lesions in acute ischaemic stroke patients with migraine

Diffusion-weighted lesions in acute ischaemic stroke patients with migraine

Stroke and Stroke-Like Symptoms in Patients with Mutations in the POLG1 Gene

Migraine-Associated Cerebrovascular Disorders

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