Risk of ischaemic stroke in people with migraine: systematic review and meta-analysis of observational studies

Etminan, Mahyar; Takkouche, Bahi; Caamaño-Isorna, Francisco; Samii, Ali

doi:10.1136/bmj.38302.504063.8f

Cited by 579 publications

(454 citation statements)

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“…The fact that migraine might be considered as a risk factor for cerebral ischaemia has long been debated [17]. To speak of this possibility, a clearly clinically defined stroke syndrome must occur remotely in time from a typical attack of migraine [18].…”

Section: Migraine and Strokementioning

confidence: 99%

Comorbid neuropathologies in migraine

et al. 2006

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The identification of comorbid disorders in migraineurs is important since it may impose therapeutic challenges and limit treatment options. Moreover, the study of comorbidity might lead to improve our knowledge about causes and consequences of migraine. Comorbid neuropathologies in migraine may involve mood disorders (depression, mania, anxiety, panic attacks), epilepsy, essential tremor, stroke, and white matter abnormalities. Particularly, a complex bidirectional relation exists between migraine and stroke, including migraine as a risk factor for cerebral ischemia, migraine caused by cerebral ischemia, migraine as a cause of stroke, migraine mimicking cerebral ischemia, migraine and cerebral ischemia sharing a common cause, and migraine associated with subclinical vascular brain lesions.

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Section: Migraine and Strokementioning

confidence: 99%

Comorbid neuropathologies in migraine

et al. 2006

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“…Migraine, especially migraine with aura, is an established risk factor for ischemic stroke (Etminan, Takkouche, Isorna, & Samii, 2005; Kurth, 2010; Schurks et al., 2009). A recent meta‐analysis of four cohorts and four case–control studies including 1,600 patients with hemorrhagic stroke, revealed a statistically significant increased risk for hemorrhagic stroke in patients with migraine (Sacco, Ornello, Ripa, Pistoia, & Carolei, 2014).…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2017

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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.

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“…The association between migraine and ischemic stroke is well demonstrated [27][28][29] . A meta-analysis of 11 case-control studies and three cohort studies published before 2004 showed that, relative to individuals without migraine, the risk of stroke was increased in migraineurs [pooled relative risk (RR)=2.16, 95% confidence interval (CI)=1.9-2.5].…”

Section: Migraine and Strokementioning

confidence: 98%

Section: Migraine and Strokementioning

confidence: 99%

“…A meta-analysis of 11 case-control studies and three cohort studies published before 2004 showed that, relative to individuals without migraine, the risk of stroke was increased in migraineurs [pooled relative risk (RR)=2.16, 95% confidence interval (CI)=1.9-2.5]. This risk was higher for MA (RR 2.27; 95% CI: 1.61-3.19), but was also apparent in patients with migraine without aura (MO, RR, 1.83; 95% CI, 1.06-3.15) 27 .More recently, two large longitudinal studies added to the evidence linking migraine and ischemic stroke (and are included in a more recent meta-analysis, summarized below). As a part of the Women's Health Study, data were prospectively gathered over more than 10 years 5 .…”

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confidence: 99%

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Migraine and Cardiovascular Disease

Lipton¹,

Bigal

2006

JAMA

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Migraine, especially migraine with aura is an established risk factor for ischemic lesions of the brain. Recent evidence has also linked migraine with and without aura to a broader range of ischemic vascular disorders including angina, myocardial infarction, coronary revascularization, claudication and cardiovascular mortality. The topic is therefore of considerable interest. Accordingly, herein we review the association between migraine and cardiovascular disease. We start by briefly presenting diagnostic criteria for migraine and revising its pathophysiology. We follow by summarizing the evidence on the topic. We then briefly present the results of a recent meta-analysis. We close by highlighting results of a large epidemiological study conducted after the publication of the meta-analysis. Key words: migraine, cardiovascular disease, stroke. Migrânea e doenças cardiovasculares RESUMOA migrânea, especialmente a migrânea com aura, é fator de risco para lesões cerebrais. Evidência recente sugere que migrânea com e sem aura é associada com outras doenças cardiovasculares isquêmicas, incluindo a angina, o infarto do miocárdio, revascularização coronária, claudicação e morte súbita. Iniciamos discutindo o diagnóstico da migrânea e seus mecanismos fisiopatológicos. Após sumarizar a evidência, discutimos resultados de meta-análise recente. Por fim, ressaltamos resultados de um grande estudo populacional sobre o assunto. Palavras-chave: migrânea, doença cardiovascular, acidente vascular cerebral. The association between migraine and ischemic vascular events has been studied for many years 1,2 . Original studies controversially reported an association between migraine with aura (MA) and stroke. The relationship was stronger in young women, and was magnified by the use of hormonal contraception or by tabagism 1 . Controversial topics included whether migraine without aura (MO) was also a risk factor to stroke, if the association also happened in men, and whether migraine was associated with other forms of cardiovascular disease 3 .The field has advanced considerably in recent years, with the publication of evidence that MA is indeed an established risk factor for subclinical ischemic lesions of the brain 4 , as well as for ischemic stroke, particularly among women of younger age 5,6 . The association has also been shown in men 7 . Furthermore, migraine seems also to be linked with other forms of cardiovascular disease (CVD), including myocardial infarct, angina and claudication), as well as with risk factors to CVD 8,9 . The topic has indeed gained considerable traction and robust evidence is now available. Accordingly, herein we review the association between migraine and CVD. We start by briefly presenting diagnostic criteria for migraine and revising its pathophysiology. We follow by summarizing the evidence on the topic. We then briefly present the results of a recent meta-analysis. We close by highlighting results of a large epidemiological study conducted after the publication of the meta-analysis. Migraine...

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Risk of ischaemic stroke in people with migraine: systematic review and meta-analysis of observational studies

Abstract: Objective To explore the association between migraine and risk of ischaemic stroke. Design Systematic review and meta-analysis.

Cited by 579 publications

References 34 publications

Comorbid neuropathologies in migraine

Comorbid neuropathologies in migraine

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

Migraine and Cardiovascular Disease

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