Migraine-related ischemic stroke?

Lantz, Maria; Kostulas, Konstantinos; Sjöstrand, Christina

doi:10.1111/ane.12069

Cited by 3 publications

(3 citation statements)

References 24 publications

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“…We therefore suggest that migraine patients may be more susceptible to infarction following ischaemic events. We found a higher rate of PFO in the migraine group, possibly responsible for ischaemic events resulting in infarction in susceptible individuals (24). This may shed light on the observed association between migraine, PFO and stroke (14,25,26).…”

Section: Discussionsupporting

confidence: 61%

Diffusion-weighted lesions in acute ischaemic stroke patients with migraine

et al. 2014

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Objectives -There is increasing knowledge about an association between migraine and ischaemic stroke. Cortical spreading depression (CSD) is the probable biological substrate of migrainous aura. To investigate the influence of CSD on the apparent stroke -migraine association, we hypothesized that magnetic resonance (MR) diffusion weighted images of acute ischaemic stroke patients would reveal an association between small cortical infarctions and migraine. Methods -We included all patients admitted to the Bergen stroke unit between 2006 and 2012 with verified acute ischaemic stroke by MR imaging. Patients were grouped in a migraine and a no-migraine group. Baseline data and clinical characteristics were analysed between the groups. Imaging data were analysed with respect to infarct location and size. Multivariate analyses were performed to adjust for confounders and provide risk estimates for observed associations. Results -A total of 1703 subjects were enrolled, 787 subjects were excluded due to uncertain or unobtainable migraine diagnosis, leaving 196 and 720 subjects in the migraine and nomigraine group, respectively. The migraine group was younger and included a higher proportion of females. There were more infarctions due to cardio-embolism (P = 0.015) and fewer due to small vessel disease (P = 0.018) in the migraine group. A higher rate of patients in the migraine group presented symptoms from the posterior circulation (P = 0.008). Migraine was associated with cortical infarctions (OR 1.8 CI: 1.3-2.5, P = 0.001). Migraine was also associated with small infarctions (OR 1.9 CI: 1.04-3.5, P = 0.038). Conclusions -Migraine was associated with small cortical infarctions. This association may be due to cortical spreading depression.

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Section: Discussionsupporting

confidence: 61%

Diffusion-weighted lesions in acute ischaemic stroke patients with migraine

et al. 2014

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“…For example, the latter condition can be interpreted to mean that Monday contains many triggering factors while Sunday contains fewer triggering factors, reducing the incidence. Since days of the week are socially defined, it is unclear what biological factor serves as a triggering 40 or delaying factor. Stress and rest are considered as candidates.…”

Section: Discussionmentioning

confidence: 99%

Weekly variations of stroke occurrence: an observational cohort study based on the Kyoto Stroke Registry, Japan

Shigematsu

Watanabe

Nakano³

2015

BMJ Open

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ObjectivesUnderstanding the temporal pattern of stroke onset and exploring the possible triggers are important strategies to reducing the incidence of stroke. If stroke occurs frequently on a specific day of the week, it is assumed that other factors, that is, ‘triggering factors’, induce stroke. The aim of the study is to investigate differences in the incidences of stroke among days of the week.DesignHospital-based registry stroke over an 11-year period.SettingKyoto Prefecture, Japan.ParticipantsA total of 13 788 patients with stroke identified from January 1999 to December 2009 inclusive in the entire Kyoto Prefecture and registered in the Kyoto Stroke Registry (KSR).Main outcome measuresPatients with stroke were classified into seven groups based on the day of the week on which stroke developed. We confirmed the differences in the incidence among days using the χ2 test and then performed multinomial logistic analysis referring to the stroke incidence on Sunday to calculate the OR and 95% CI of the stroke occurrence on each day of the week.ResultsThe OR (95% CI) for stroke occurring on Monday, Tuesday, Wednesday, Thursday, Friday and Saturday was 1.157 (1.030 to 1.293), 1.101 (0.981 to 1.236), 1.059 (0.943 to 1.188), 1.091 (0.972 to 1.225), 1.053 (0.938 to 1.205) and 1.074 (0.956 to 1.205), respectively. After stratification by stroke subtypes, cerebral infarction occurred more frequently on Monday than on Sunday (OR and 95% CI were 1.189 and 1.034 to 1.366, p=0.014) independent of age and gender. There was no significant day of the week variation in cerebral haemorrhage or subarachnoid haemorrhage.ConclusionsSome factors that arise periodically appear to affect the incidence of cerebral infarction, which gradually develops over years, and this suggests an aetiological mechanism different from the conventional cumulative effect of risk factors due to long-term exposure. We propose a hypothesis that there is a ‘triggering factor’ for the development of cerebral infarction.

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“…The differential diagnosis of especially PC stroke includes other neurological diseases with similar symptoms, including migraine. The authors of a case series of six migraine patients with ischemic stroke discussed whether an impending infarction could have induced or mimicked a migraine attack . In a larger AIS cohort, migraine was associated with small cortical DWI lesions in the posterior circulation.…”

Section: Discussionmentioning

confidence: 99%