Migraine prevalence in patients with unruptured intracranial aneurysms: A case–control study

Abstract

ObjectivesMigraine is a suggested risk factor for aneurysmal subarachnoid hemorrhage (aSAH). An increased risk of aSAH in migraineurs may be explained by an increased prevalence of unruptured intracranial aneurysms (UIA). We performed a case–control study to compare lifetime migraine prevalence in patients with UIA, patients with a history of transient ischemic attact (TIA) or ischemic stroke and controls without a history of aSAH, TIA or ischemic stroke.Materials and MethodsPatients with UIA were recruited from two university hospitals. Data on patients with TIA/stroke were retrieved from a previous study. Partners of patients with UIA or TIA/stroke were included as controls. Migraine history was assessed via a telephone interview based on the International Classification of Headache Disorders, second edition criteria. We calculated odds ratios (OR) for migraine with univariable and multivariable logistic regression analyses, adjusted for age, sex, hypertension and smoking.ResultsWe included 172 patients with UIA, 221 patients with TIA or stroke, and 164 controls. In UIA patients, migraine prevalence was 24.4% compared with 14.6% in controls (UIA vs. controls; OR 1.9; 95% confidence interval [CI] 1.1–3.5) and 22.2% in TIA/stroke patients (UIA vs. TIA/stroke; OR 1.1; 95% CI 0.7–1.8). After adjustments, the OR for migraine in UIA patients versus controls were 1.7 (95% CI 1.0–3.1) and 0.9 (95% CI 0.5–1.0) versus TIA/stroke. Results were comparable for migraine with and without aura.ConclusionsMigraine prevalence is possibly increased in patients with UIA compared with controls and comparable with the prevalence in patients with TIA or stroke. Further studies are needed to confirm our findings and to investigate the underlying pathophysiology.

The burden of headache following aneurysmal subarachnoid hemorrhage: a prospective single-center cross-sectional analysis

“…Interestingly, one recent case-control study revealed an increased migraine frequency also in patients with unruptured intracranial aneurysms [68]. The pathophysiology behind the development of persistent post-stroke headache is principally not understood so far and thus speculative.…”

Case Report: Migraine-Like Headache With Visual Aura Initiated by Endovascular Coiling Treatment for a Posterior Cerebral Artery Aneurysm

“…A higher prevalence of migraine headaches with or without aura in patients with cranial aneurysm ( 8 ) and improvement of the preexisting migraine headache after endovascular treatment with either coiling or clipping ( 17 ) indicate that cranial aneurysm is a causative factor for migraine. Cranial aneurysms may be saccular, fusiform, or dissecting and can be located at various segments of the cranial artery.…”

“…For example, moyamoya disease has been recognized to be the cause of migraine-like headaches for long time ( 5 ), and carotid-cavernous fistula and dissections of intracranial and cervical arteries are reported to be the cause of migraine-like headaches ( 6 , 7 ). Another form of brain vascular alteration, cervical, anterior, and middle cerebral artery aneurysm, is also demonstrated to be associated with increased prevalence of migraine headaches with or without aura ( 8 ), and surgical treatment with either coil embolization or clipping relieved the recurrent headaches ( 9 – 11 ), indicating that cranial aneurysm is a causative factor of migraine. Posterior cerebral artery (PCA) aneurysm is a rare condition, and its association with migraine is rarely reported.…”

The Association between Migraine and Abdominal Aortic Aneurysms: A Nationwide Population-Based Cohort Study

“…Patients with migraine also had an increased risk of AF [ 31 , 32 ]. Migraine prevalence is increased in patients with intracranial aneurysms (ICAs) [ 33 , 34 ]. Our previous study revealed an association between ICAs and aortic aneurysms, and open surgical repair was associated with fewer recognized ICAs than nonsurgical treatment [ 35 ].…”