Clinical Features of Stroke in Migraine: A Review

Abstract

SYNOPSIS High resolution CT scanning in patients with post‐traumatic head pain is superior to conventional radiography for detecting fractures and other lesions of the facial structures. This is an important consideration, since such lesions may be responsible for the post‐traumatic pain. Direct axial and coronal scanning is adequate for diagnosis in most cases; multiplanar reconstructions can be done to obtain sagittal and other views. The radiation dose and cost of CT are comparable to those of conventional tomography.

Ischemic stroke and active migraine

“…4 In patients with IS under the age of 45, we noted a higher percentage of oral contraceptive use and multivariate analysis showed that this factor was characteristic of migraine. 12,26,29,30 In our study, as in others, 26,30 we found a more gradual neurologic deficit onset (a characteristic feature of migraine) in migraineurs younger than age 45 years compared with control subjects. 4 Although a significant positive association between spontaneous arterial dissection and migraine has been previously reported, 24 we found that, irrespective of age, arterial dissection was no more frequent in migraineurs than in control subjects.…”

“…Oral contraceptive use has been shown to predispose women to IS 23 and to increase the risk of brain ischemia in migrainous women. 12,20,25,29,30 We also found headache to be more common at clinical presentation in both groups of migraineurs than in control subjects, but the prevalence of headache was twice as high in young migraineurs with mainly frontal localization compared with migraineurs aged 45 and older, in agreement with the higher proportion of ISODAM in young migraineurs. In young migraineurs, we noted 24 with ISODAM.…”

Stroke from other etiologies masquerading as migraine-stroke.

“…These patients demonstrate that important and different etiologies may produce what seems to be the migraine-stroke syndrome. The result may be failure to recognize specific therapeutic measures that could have vitally important benefit to the patient {Stroke 1991^22:1068-1074) U ntil 1 recently, cerebral infarction related to migraine was considered rare, with only 64 cases reported before 1983. 1 Several recent publications suggest that "migraine-stroke" is more common than was previously suspected, 2 -3 but the mechanism leading to the stroke is still not well understood.…”

Migraine and Intracerebral Hemorrhage

“…It is well known that some patients with migraine can develop lasting neurological deficits resulting from cerebral infarction (1). Less well known is the rare phenomenon of cerebral hemorrhage during an episode of migraine in a normotensive patient with no risk factors for cerebral hemorrhage (2).…”