Migraine Sufferers May Be at Greater Risk of Ischemic Stroke


Stroke, a journal of the American Heart Association published an article by Alessandro Pezzine, Giorgio Busto, Marialuisa Zedde, et al., (Stroke. 2018:published online Feb 20) suggesting that migraine sufferers may be more vulnerable to an infarction during the cerebral ischemia that may accompany migraine. These investigators examined the potential correlation between migraine and brain ischemia in a multicenter cohort of patients with acute ischemic stroke who had CT perfusion and were scheduled for reperfusion therapy. They compared the proportion of subjects with (n = 61) and without migraine (n = 61) who had mismatch versus no mismatch and for volume of penumbra salvaged and final infarct size.

Patients with migraine had a higher proportion of no-mismatch (29.7%, P > .039) compared to patients without migraine (11.5%) and was also more prominent in patients who had migraine with aura. Migraine, especially migraine with aura, was independently associated with a no-mismatch pattern (odds ratio, 2.65; 95% CI, 0.95–7.41 for migraine; odds ratio, 5.54; 95% CI, 1.28–23.99 for migraine with aura). Patients with migraine with aura had smaller volumes of salvaged penumbra (9.8±41.2 mL) compared both to those with migraine without aura and those without migraine. There was no difference in final infarct size among the 3 migraine subgroups (P=0.312).

The author conclude that migraine may increase individual vulnerability to ischemic stroke during the process of acute brain ischemia and that this could represent a new therapeutic target. 


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