Sensitivity to acute cerebral ischemic injury in migraineurs

Mawet, Jérôme; Eikermann-Haerter, Katharina; Park, Kwang‐Yeol; Helenius, Johanna; Daneshmand, Ali; Pearlman, Lea; Avery, Ross; Negro, Andrea; Velioglu, Murat; Arsava, Ethem Murat; Ay, Hakan; Ayata, Cenk

doi:10.1212/wnl.0000000000002166

Cited by 33 publications

(40 citation statements)

References 10 publications

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“…An increased susceptibility to acute ischemic injury has been demonstrated in patients with migraine, due to an unstable penumbra, especially in those with MwA. 33 Greater susceptibility to spreading depolarization in migraine-susceptible brains may be another potential mechanism for increased cerebral vulnerability to ischemia and stroke. Similar findings have been reported in an animal study.…”

Section: Discussionmentioning

confidence: 99%

Cerebellar Hypoperfusion in Migraine Attack: Incidence and Significance

Kellner-Weldon¹,

El-Koussy²,

Jung

et al. 2018

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE:Patients diagnosed with migraine with aura have an increased lifetime risk of ischemic stroke. It is not yet clear whether prolonged cortical hypoperfusion during an aura increases the immediate risk of cerebellar infarction because it may induce crossed cerebellar diaschisis and subsequent tissue damage. To address this question, we retrospectively analyzed potential relationships between cortical oligemia and cerebellar hypoperfusion in patients with migraine with aura and their potential relation to small infarct-like cerebellar lesions.

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Section: Discussionmentioning

confidence: 99%

Cerebellar Hypoperfusion in Migraine Attack: Incidence and Significance

Kellner-Weldon¹,

El-Koussy²,

Jung

et al. 2018

AJNR Am J Neuroradiol

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“…These studies did not control for any effect of migraine on the prognosis of stroke. Studies on ischemic depolarization suggested that migraineurs could have an accelerated loss of viable tissue in the area at risk for infarction . Also, different follow‐up periods and endpoints used make it difficult to compare the studies.…”

Section: Headache Related To Ischemic Stroke As a Marker Of Severitymentioning

confidence: 99%

Headaches Attributed to Ischemic Stroke and Transient Ischemic Attack

Oliveira

Rocha-Filho

2019

Headache

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Introduction Although headaches attributed to ischemic strokes and transient ischemic attack occur frequently, they are often overlooked and underdiagnosed as manifestations of cerebrovascular disease. Method This is a narrative review. Results The prevalence of headache attributed to ischemic stroke varies between 7.4% and 34% of cases and of headache attributed to transient ischemic attack, from 26% to 36%. Headache attributed to ischemic stroke is more frequent in younger patients, in migraineurs, in those who have suffered a larger stroke, a posterior circulation infarction, or a cortical infarction, and is less frequent in lacunar infarctions. The most common pattern of headache attributed to ischemic stroke is a mild to moderate bilateral pain, not associated with nausea, vomiting, photophobia, or phonophobia. This headache usually has a concomitant onset with focal neurologic deficit and improves over time. The few studies that have assessed the value of headache for a prognosis of ischemic strokes have demonstrated conflicting results. There are no clinical trials on pain management or prophylactic treatment of persistent headache attributed to ischemic stroke. Conclusion Headache attributed to ischemic stroke is frequent and usually has a tension‐type headache pattern. Its frequency varies according to the stroke’s etiology. Further studies are required on pain management, prophylactic treatment, and characteristics of this headache.

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“…Gene mutations possibly increase the vulnerability to stroke by facilitating ischemic depolarizations, a mechanism linked to glutamatergic hyperexcitability, and to large perfusion defects after cerebral ischemia . Studies on ischemic depolarization could explain the accelerated loss of viable tissue in migraineurs at risk for infarction, particularly those with MA …”

Section: Pathophysiological Considerationsmentioning

confidence: 99%

“…29 Studies on ischemic depolarization could explain the accelerated loss of viable tissue in migraineurs at risk for infarction, particularly those with MA. 31 Migraine aura is a transient, focal brain disturbance due to CSD development, associated with concurrent cerebral blood flow reduction. 26,27 The spreading brain oligemia appears dissociated from neuronal responses to CSD as demonstrated by prolonged hypoperfusion without aura symptoms.…”

Section: Pathophysiological Considerationsmentioning

confidence: 99%

Migraine and cerebrovascular diseases: Epidemiology, pathophysiological, and clinical considerations

Magalhães

Rocha-Filho

2018

Headache

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Migraine and cerebrovascular diseases are disabling disorders, which are possibly closely interrelated. Heterogeneous and scattered evidence in literature remains a challenge. We searched for systematic reviews including diverse cerebrovascular events in migraineurs and reported relevant original studies to update the evidence when necessary. The studies show that migraine is associated with increased risk of transient ischemic attacks, any stroke, and possibly hemorrhagic stroke. In addition, migraine with aura increases the risk of ischemic stroke and white matter abnormalities. Migraine without aura increases the risk of cervical artery dissection as a cause of ischemic stroke. Groups with specific risk profiles are women, young people, smokers, and oral contraceptive users. The pathophysiology of the association remains uncertain. However, genetic and environmental factors may be involved in intricate mechanisms responsible for oxidative stress, vascular dysfunction and, ultimately, vascular events. In conclusion, migraine is a potential risk factor for cerebrovascular diseases. Migraineurs should be carefully evaluated considering their vascular risk assessment based on current evidence, so that healthcare professionals can provide appropriate and individualized management of other cardiovascular risk factors, notably quitting smoking and restricting use of oral contraceptives.

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Sensitivity to acute cerebral ischemic injury in migraineurs

Abstract: This case-control study supports the hypothesis that a history of migraine, particularly with aura, is associated with a no-mismatch pattern during acute ischemic stroke, consistent with data obtained in migraine mutant mice.

Cited by 33 publications

References 10 publications

Cerebellar Hypoperfusion in Migraine Attack: Incidence and Significance

Cerebellar Hypoperfusion in Migraine Attack: Incidence and Significance

Headaches Attributed to Ischemic Stroke and Transient Ischemic Attack

Migraine and cerebrovascular diseases: Epidemiology, pathophysiological, and clinical considerations

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