Background: There is controversy as to whether migraine is associated with white matter abnormalities (WMAs) on magnetic resonance images. These abnormalities may be important as a risk factor for future stroke. Further, it is controversial whether any increased risk of WMAs is attributable to comorbidities such as vascular disease. Methods: A meta-analysis of published case-control studies was undertaken to address the relationship between migraine and magnetic resonance imaging WMAs. Seven studies were identified. Data from studies reporting the incidence of magnetic resonance imaging WMAs in those with migraine and appropriate control populations were used to calculate odds ratios for WMAs in migraine for each study. A stratified meta-analysis was performed using studies that did and did not exclude subjects with disease comorbidities. Results: The summary odds ratio shows that those with migraine are at increased risk for WMAs (odds ratio, 3.9 [95% confidence interval, 2.26-6.72]). The risk does not differ between studies that included subjects with comorbidities and those that did not. Conclusion: This meta-analysis demonstrates that subjects with migraine are at higher risk of having WMAs on magnetic resonance images than those without migraine. This increased risk is present even in younger individuals who do not have co-occurring cerebrovascular disease risk factors. Prospective studies are needed to determine whether the increased risk of stroke in migraine is mediated or foreshadowed by the presence of WMAs.

Purpose: We sought to determine the incidence, etiology, characteristics and risk factors for all headaches in the first week postpartum. Methods:This was a prospective cohort study of 985 women delivering over a three-month period in a single tertiary-care institution. These women underwent a structured interview and follow-up to collect demographic data and to assess for the presence and characteristics of postpartum headache (PPHa) or neck/shoulder pain. All headaches were diagnosed using an algorithm based on the diagnostic criteria of the International Headache Society. Multivariate analysis was used to examine possible risk factors.Results: Three hundred eighty-one of the 985 study participants (39%) reported headaches or neck/shoulder pain during the study period. The median time to onset of the PPHa was two days (0, 6; 1st and 3rd quartiles) and duration was four hours (2, 24; 1st and 3rd quartiles). Primary headaches accounted for > 75% of PPHa. Only a small number of headaches (4%) were incapacitating. Postdural puncture headache accounted for 4.7% of all PPHa. Significant risk factors for the development of PPHa were: known inadvertent dural puncture [odds ratio (OR) adj = 6.36; 95% confidence interval (CI) 1.29, 31.24]; previous headache history (1-12/yr-OR adj = 1.57; 95% CI 1.01, 2.44; > 12/yr-OR adj = 2.25; 95% CI 1.63, 3.11); multiparity (OR adj = 1.37; 95% CI 1.03, 1.82) and increasing age (OR adj = 1.03/yr; 95% CI 1.00, 1.06). Conclusions: Postpartum headaches are common, often first noted after discharge from hospital. The majority are related to primary headache disorders. Increased awareness of this epidemiological relationship and improved diagnosis of primary headache conditions may lead to improved headache-specific therapy and avoidance of unnecessary investigations or readmission to hospital. 1,29, 31,24] ; des antécédents de céphalées 57 ; IC de 95 % 1,01,2,44 ;25 ; IC de 95 % 1,63,3,11) ; la multiparité (RR aju =1,37 ; IC de 95 % 1,03,1,82) et l'âge croissant (RR aju = 1,03/an ; IC de 95 % 1,00,1,06 Objectif

Patients with high intramedullary signal change on T2WI who do not have clonus or spasticity may experience a good surgical outcome and may have reversal of the MRI abnormality. A less favorable surgical outcome is predicted by the presence of low intramedullary signal on T1WI, clonus, or spasticity. These data suggest that there may be a window of opportunity to obtain optimal surgical outcomes in patients with CSM.

This study supports previous observations that migrainous infarction mostly occurs in the posterior circulation, and in younger women with a history of migraine with aura. Acute ischemic lesions were often multiple and located in distinct arterial territories. As there were no overlapping ischemic lesions, hemodynamic compromise during the development of migraine is unlikely the cause of infarction. Differentiation between migrainous infarction and prolonged migraine aura is difficult and associated with delayed admission of patients.