Inherited Prothrombotic Risk Factors in Children With Stroke, Transient Ischemic Attack, or Migraine

Abstract

Factor V G1691A has an important role in susceptibility to arterial ischemic stroke, both in the perinatal/neonatal period and in childhood, as well as transient ischemic attacks. A minor impact of human platelet alloantigen polymorphisms suggests that platelet glycoprotein polymorphisms may increase the risk of transient ischemic attacks and migraine, but this should be confirmed in larger studies.

The Headaches and Polymorphisms of the Methylenetetrahydrofolate Reductase

“…No association was found in Spanish and Portuguese migraineurs with TT genotype [10,12,13] Lorenz et al analyzed MTHFR 677TT polymorphism in a group of Estonian pediatric migraineurs and did not detect a close link with migraine prevalence [14] MTHFR C677T variant differently occur in different countries, so it could be considered an ethnic-specific polymorphism [14]. In the pathogenesis of aura migraine is hereby accepted the concept of "cortical spreading depression (CSD)", in the aura phase there is a cerebral oligoemia that starts to spread anteriorly and a condition of hyperemia follows to this [15,16].…”

“…A case study conducted in pediatric patients suffering from stroke, confirms the presence of hyperhomocysteinemia among the causal factors of stroke [19][20][21]. According to recent publications, migraine headache, especially those with aura, however, it could be conceived as the pathological mediator between the mutation and the phenotypic outcome of stroke [11,13]. In a study of Lea et al on 52 patients suffering from aura migraine with increased levels of homocysteine, it was administered to patients vitamin supplementation, as homocysteine levels decreased frequency and severity of migraine attacks declined [22] In the trial of Di Rosa et al on 16 children with MA and high levels of homocysteine the folic acid supplementation, induced the reduction of migraine attacks in 6 children and in 10 patients did not occur migraine attacks [23].…”

“…Among the causes of such anomalies, in addition to the patent foramen ovale, high blood pressure and other risk factors for stroke, such as cigarette smoking, use of oral contraceptives, obesity, hypercholesterolemia, there is the MTHFR C677T mutation. An elevated plasma vWF activity is associated with MTHFR TT genotypes, so it represents a connection between migraine and ischemic predisposition [13,18]. A case study conducted in pediatric patients suffering from stroke, confirms the presence of hyperhomocysteinemia among the causal factors of stroke [19][20][21].…”

“…In a study of Bottini et al was analyzed the prevalence of homozygous variant of an Italian study population, it was identified a trend towards an increased incidence of migraine in subjects who carried the mutation [8]; another study examined a group of Croatian pediatric patients suffering from migraine, the 677TT genotype was associated with an higher risk of migraine [11]. No association was found in Spanish and Portuguese adult migraineurs [13,14]. Lorenz et al analyzed MTHFR 677TT polymorphism in a group of Estonian pediatric migraineurs and did not detect a close link with migraine prevalence [14].…”

Are Methylenetetrahydrofolate Reductase (<i>MTHFR</i>) Gene Polymorphisms C677T and A1298C Associated with Higher Risk of Pediatric Migraine in Boys and Girls?

“…A trend for migraine was reported in Italian patients who were 677TT and 1298CC homozygous carriers [24]. In the Croatian pediatric migraine population, no statistically significant association with migraine in carriers of 677CT polymorphism was found, but a trend toward an increased risk for migraine in patients who had homozygous variant 677TT was found [25]. It is believed that associations between childhood migraine and MTHFR polymorphisms show different patterns across populations.…”