Migraine and Hemorrhagic Stroke

Sacco, Simona; Ornello, Raffaele; Ripa, Patrizia; Pistoia, Francesca; Carolei, Antonio

doi:10.1161/strokeaha.113.002465

Cited by 153 publications

(130 citation statements)

References 31 publications

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“…Although the results of individual studies were conflicting, a recent meta-analysis showed that migraine is associated with a 1.48-fold increase in the risk of hemorrhagic stroke, including subarachnoid hemorrhage. RR was not significant higher for MA group, but only for women and for age \45 years, regardless of M subtype [11]. In another study, MA has been associated with HS, and risk was stronger in the subset of women with fatal HS and \55 years of age [12].…”

Section: Epidemiological Datamentioning

confidence: 84%

Migraine with aura: which patients are most at risk of stroke?

Falco

2015

Neurol Sci

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The complex association between migraine (M) and ischemic stroke (IS) is discussed. Epidemiological studies and meta-analyses show that M with aura (MA) and not M without aura, doubles the risk of IS. The risk is higher for female gender, young age and higher headache attacks frequency. Smoking habit and oral contraceptives, especially if associated, increase stroke risk. The underlying pathogenetic mechanisms are not completely understood, but it is hypothesized that a particular brain susceptibility to cortical spread depression could explain the association between MA and IS. The absolute risk of IS in migraineurs is relatively low and an antithrombotic primary prevention is not indicated, but it is mandatory to investigate and treat associated risk factors for IS and, in young MA women, consider only progestinic oral contraceptives, if needed, and smoking cessation.

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Section: Epidemiological Datamentioning

confidence: 84%

Migraine with aura: which patients are most at risk of stroke?

Falco

2015

Neurol Sci

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“…While an association between migraine and stroke has not been confirmed in migraine-without-aura patients, 97 the risk of both ischemic and hemorrhagic 98 stroke is two to three times higher in migraine-with-aura patients. There may, however, be other more profound vascular risks present in these patients who were not accounted for in the studies.…”

Section: Migraine As Risk Factor For Strokementioning

confidence: 98%

Gender Differences in Neurologic Emergencies Part I: A Consensus Summary and Research Agenda on Cerebrovascular Disease

Madsen

Seigel²,

Mackenzie

et al. 2014

Acad Emerg Med

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Cerebrovascular neurologic emergencies including ischemic and hemorrhagic stroke, subarachnoid hemorrhage (SAH), and migraine are leading causes of death and disability that are frequently diagnosed and treated in the emergency department (ED). Although sex and gender differences in neurologic emergencies are beginning to become clearer, there are many unanswered questions about how emergency physicians should incorporate sex and gender into their research initiatives, patient evaluations, and overall management plans for these conditions. After evaluating the existing gaps in the literature, a core group of ED researchers developed a draft of future research priorities. Participants in the 2014 Academic Emergency Medicine consensus conference neurologic emergencies working group then discussed and approved the recommended research agenda using a standardized nominal group technique. Recommendations for future research on the role of sex and gender in the diagnosis, treatment, and outcomes pertinent to ED providers are described for each of three diagnoses: stroke, SAH, and migraine. Recommended future research also includes investigation of the biologic and pathophysiologic differences between men and women with neurologic emergencies as they pertain to ED diagnoses and treatments.ACADEMIC EMERGENCY MEDICINE 2014;21:1403-1413 by the Society for Academic Emergency Medicine C erebrovascular neurologic emergencies such as ischemic and hemorrhagic stroke, subarachnoid hemorrhage (SAH), and migraine are among the most lethal and disabling conditions presenting to the emergency department (ED). We have made great strides in understanding and treating these conditions, and our efforts have led to improved outcomes for these patients. Sex-and gender-based distinctions, however, are only recently becoming clearer, and much work is needed to explain the differences observed between men and women. After a focused review of the current literature on preclinical, clinical, and outcomes differences between women and men, and then the consensus process, we propose a research agenda in the areas of stroke, SAH, and headache/migraine. METHODSAfter evaluating the current literature, the authors, all emergency medicine (EM) researchers, proposed an agenda for future research. Consensus was reached using an iterative process through the four-part nominal group technique as already described in the executive summary. 1 A multidisciplinary group of participants (EM, critical care medicine, internal medicine, physical and rehabilitation medicine) prioritized the final iteration of themes/questions using the Poll Everywhere Web-based voting method. Descriptive statistics were calculated to tabulate the final list of questions presented below. The proposed research questions were then discussed and voted on by participants in the Academic Emergency Medicine consensus conference neurologic emergencies working group (see footnote for listing) at the meeting in May 2014. STROKE Epidemiology/OutcomesStroke is the fourth leading ca...

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“…[11] In addition, there are several published reports suggesting that migraine is a risk factor for stroke. [7,10,17] On the other hand, there are studies that did not demonstrate that migraine was a risk factor for cardiovascular events. Liman et al indicated that there was no significant difference in CAIMT and peripheral arterial tonometry (PAT) ratio in female patients with migraine with aura.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Subclinical Atherosclerosis in Migraine Patients by Ultrasound Radiofrequency-Data Technology, Preliminary Results

Tatar

Ergün

Celtikci

et al. 2016

Agri

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SummaryObjectives: Migraine is a headache disorder affecting approximately 12% of the population, predominantly female individuals. Migraine has been associated with vascular events such as stroke and cardiovascular disease. The close connection between these vascular disorders and atherosclerosis is well known. Carotid artery intima-media thickness (CAIMT) is a marker for detection of subclinical atherosclerosis. The present study is an analysis of the presence of subclinical atherosclerosis in migraine patients. Methods: CAIMT was evaluated in 25 female migraine patients and 27 female controls using innovative ultrasound (US) radiofrequency (RF) data technology. Mann-Whitney U test was used to compare measurements in patient and control groups. Results: There was a statistically significant difference between mean CAIMT of migraine patients and control group (p<0.005): mean CAIMT was 701±114 μm in migraine patients and 400±64 μm in control group. Conclusion: Migraine patients are more prone to atherosclerosis compared to healthy individuals. CAIMT measurement with sonography can be utilized in follow-up to detect subclinical atherosclerosis.Keywords: Carotid; intima-media thickness; migraine; ultrasound radiofrequency data technology. ÖzetAmaç: Migren, toplumun yaklaşık %12'sini ve ağırlıklı olarak da kadın bireyleri etkileyen bir baş ağrısı bozukluğudur. Migren, inme ve kalp-damar hastalığı gibi vasküler patolojiler ile ilişkilendirilmiştir. Bu vasküler bozukluklar ile ateroskleroz arasındaki yakın bağlantı iyi bilinmektedir. Karotis arter intima media kalınlığı, subklinik aterosklerozun saptanması için bir göstergedir. Biz bu çalışmada; migren hastalarında subklinik aterosklerozun varlığını incelemeyi amaçladık. Gereç ve Yöntem: Karotis arter intima media kalınlığı, 25 kadın migren hastasında ve 27 kadın kontrol grubunda yeni bir teknik olan ultrason radyofrekans-veri teknolojisi ile değerlendirildi. Hasta ve kontrol gruplarında fark varlığını analiz etmek için Mann-Whitney U testi kullanıldı. Bulgular: Migren hastaları ve kontrol grubu arasında ortalama karotis intima media kalınlığı açısından istatistiksel olarak anlamlı fark saptandı (p<0.005). Ortalama karotis intima media kalınlığı migren hastalarında 701±114 mikrometre iken kontrol grubunda 400±64 mikrometre ölçüldü. Sonuç: Migren hastaları, sağlıklı bireylere oranla ateroskleroza daha yatkındır. Sonografi ile karotis arter intima media kalınlığı ölçümü bu hastalarda subklinik aterosklerozun tanınması amacıyla takiplerde kullanılabilir.Anahtar sözcükler: Karotis; intima media kalınlık; migren; ultrason radyofrekans-veri analizi.

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Migraine and Hemorrhagic Stroke

Cited by 153 publications

References 31 publications

Migraine with aura: which patients are most at risk of stroke?

Migraine with aura: which patients are most at risk of stroke?

Gender Differences in Neurologic Emergencies Part I: A Consensus Summary and Research Agenda on Cerebrovascular Disease

Evaluation of Subclinical Atherosclerosis in Migraine Patients by Ultrasound Radiofrequency-Data Technology, Preliminary Results

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