The Migraine–Stroke Connection

Lee, Mi Ji; Lee, Chungbin; Chung, Chin‐Sang

doi:10.5853/jos.2015.01683

Cited by 53 publications

(64 citation statements)

References 139 publications

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“…The incidence of migrainous infarction is low, accounting for 0.2-0.5% of all cerebral ischemic causes 33 , 34. The physiopathology is still uncertain; however, the main hypothesis relates to an imbalance in the vessels’ control with severe vasoconstriction followed by downstream ischemia 30. The territory of the posterior circulation is mostly involved (70-82%).…”

Section: Discussionmentioning

confidence: 99%

Migrainous infarction: a rare and often overlooked diagnosis

Kreling¹,

Neto²,

Neto³

2017

Autops. Case Rep.

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Migraine is a neurological entity and a well-known independent risk factor for cerebral infarction, which mostly afflicts the young female population. Researching focal neurological signs in this subset of the population with the diagnosis of a neurological ischemic event should always take into account the migraine as the etiology or as an associated factor. The etiology of central nervous system (CNS) ischemia is considerable. Migraine, although rare, also may be included in this vast etiological range, which is called migrainous infarction. In this setting, the diagnostic criteria required for this diagnosis is extensive. Herein, we present the case of a female adolescent who submitted to the emergency facility complaining of diplopia, dysarthria, and imbalance, which started concomitantly with a migrainous crisis with aura—a challenging clinical case that required extensive research to address all possible differential diagnoses.

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Section: Discussionmentioning

confidence: 99%

Migrainous infarction: a rare and often overlooked diagnosis

Kreling¹,

Neto²,

Neto³

2017

Autops. Case Rep.

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“…An association between migraine and vascular diseases has been discussed [20]. It was suggested that the risk of ischemic stroke increases along with the increase in frequency of migraine attacks [21].…”

Section: Discussionmentioning

confidence: 99%

Lipoprotein(a)-hyperlipoproteinemia as cause of chronic spinal cord ischemia resulting in progressive myelopathy – successful treatment with lipoprotein apheresis

Heigl

Hettich

Mauch

et al. 2017

Clin Res Cardiol Suppl

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High concentrations of lipoprotein(a) (Lp(a)) represent an important independent and causal risk factor associated with adverse outcome in atherosclerotic cardiovascular disease (CVD). Effective Lp(a) lowering drug treatment is not available. Lipoprotein apheresis (LA) has been proven to prevent cardiovascular events in patients with Lp(a)-hyperlipoproteinemia (Lp(a)-HLP) and progressive CVD. Here we present the course of a male patient with established peripheral arterial occlusive disease (PAOD) at the early age of 41 and coronary artery disease (CAD), who during follow-up developed over 2 years a progressive syndrome of cerebellar and spinal cord deficits against the background of multifactorial cardiovascular risk including positive family history of CVD. Spastic tetraplegia and dependency on wheel chair and nursing care represented the nadir of neurological deficits. All conventional risk factors including LDL-cholesterol had already been treated and after exclusion of other causes, genetically determined Lp(a)-HLP was considered as the major underlying etiologic factor of ischemic vascular disease in this patient including spinal cord ischemia with vascular myelopathy. Treatment with an intensive regimen of chronic LA over 4.5 years now was successful to stabilize PAOD and CAD and led to very impressive neurologic and overall physical rehabilitation and improvement of quality of life.Measurement of Lp(a) concentration must be recommended to assess individual cardiovascular risk. Extracorporeal clearance of Lp(a) by LA should be considered as treatment option for select patients with progressive Lp(a)-associated ischemic syndromes.

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“…In selected cases, migraine prophylaxis which is beneficial to reduce both migraine attacks and vascular risk, should be considered. [8] There are some limitations of our study. A limited number of patients have been included in this study, and migraine headache severity could not be evaluated from the patients' data.…”

mentioning

confidence: 91%

Cardiovascular risk factors and white matter hyperintensities in migraine without aura patients

Uçar

Güneş²,

Demircan³

et al. 2017

Agri

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SummaryObjectives: White matter hyperintensities (WMHs) are observed in patients with migraine with aura (MWA) and without aura (MWO), but there are a limited number of studies regarding patients with MWA. In this study, we aimed to investigate the cardiovascular risk factors which may play a role in the development of WMHs in patients with MWO. Methods: This observational, analytical, case-control study was conducted between June 2016 and January 2017. It included 21 patients with MWO who had WMHs on brain MRI and 19 patients with MWO who tested normal on MRI (control group) at the Neurology Department Outpatient Polyclinic, Ankara Training and Research Hospital. The patients' data (history, family history, neurological examination findings, echocardiography findings, and cerebral MRI findings) were retrospectively reviewed. Results: Age, gender, body mass index, blood lipid level, migraine duration, localization of headache, average number of headache per month, medication for headache attack, and echocardiography findings were similar between the two groups. (p>0.05). Conclusion:In this study, we did not find any association between cardiovascular risk factors and WMHs development in patients with MWO. The association of risk factors other than cardiovascular risk factors (genetic factors and oxidative stress) with the development of WMHs in patients with MWO should also be studied in future.Keywords: Cerebral white matter hyperintensities; migraine without aura; risk factors. ÖzetAmaç: Beyaz cevher hiperintensiteleri (BCH) hem auralı migrenli (MWA), hem de aurasız migrenli (MWO) li hastalarda görül-mekle birlikte, MWA'lı hastalarda sınırlı sayıda çalışma yapılmıştır. Biz bu çalışmada MWA'lı hastalarda BCH'lerinin gelişiminde rol oynayan kardiyovasküler risk faktörlerini araştırmayı amaçladık. Gereç ve Yöntem: Bu gözlemsel, analitik, vaka-kontrol çalışması Temmuz 2016-Ocak 2017 tarihleri arasında Ankara Eğitim ve Araştırma Hastanesi Nöroloji Polikliniği'ne başvuran, MWO tanısı almış ve serebral MRG 'da BCH saptanan 21 olgu ve kontrol grubu olarak serebral MRG'da BCH saptanmayan 19 MWO olgusu ile yapılmıştır. Hastaların yaş, cinsiyet, beden kitle indeksleri, kan lipid düzeyleri, migren hastalık süresi, başağrısının lokalizasyonu, aylık ortalama başağrısı sayısı, atakta kullanılan ilaçlar ve ekokardiyografi bulguları retrospektif olarak gözden geçirildi. Bulgular: Hastaların yaş, cinsiyet, beden kitle indeksleri, total kolesterol (kol), migren hastalık süresi, başağrısının lokalizasyonu, aylık ortalama başağrısı sayısı, atakta kullanılan ilaçlar ve ekokardiyografi bulguları benzerdi. (p>0.05) Sonuç: Çalışmamızda kardiyovasküler risk faktörleri ile MWO hastalarında BCH gelişimi arasında ilişki bulmadık. Kardiyovasküler risk faktörleri dışındaki risk faktörleri ( genetik faktörler ve oksidatif stress vb) nin MWO'lı olgularda BCH gelişimindeki rolleri araştırılmalıdır.Anahtar sözcükler: Aurasız migren; risk faktörleri; serebral beyaz cevher hiperintensiteleri.

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The Migraine–Stroke Connection

Cited by 53 publications

References 139 publications

Migrainous infarction: a rare and often overlooked diagnosis

Migrainous infarction: a rare and often overlooked diagnosis

Lipoprotein(a)-hyperlipoproteinemia as cause of chronic spinal cord ischemia resulting in progressive myelopathy – successful treatment with lipoprotein apheresis

Cardiovascular risk factors and white matter hyperintensities in migraine without aura patients

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