Migraine and cerebrovascular diseases: Epidemiology,pathophysiological, and clinical considerations |
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| Authors: | João Eudes Magalhães MD PhD Pedro Augusto Sampaio Rocha‐Filho MD PhD |
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| Affiliation: | 1. Postgraduate program in Neuropsychiatry and Behavioral Sciences, Universidade Federal de Pernambuco (UFPE), Pernambuco, Brazil;2. Stroke Clinic, Hospital Universitario Oswaldo Cruz, Universidade de Pernambuco (UPE), Recife, Brazil;3. Department of Neuropsychiatry, Universidade Federal de Pernambuco (UFPE), Recife, Brazil;4. Headache Clinic, Hospital Universitario Oswaldo Cruz, Universidade de Pernambuco (UPE), Recife, Brazil |
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| Abstract: | Migraine and cerebrovascular diseases are disabling disorders, which are possibly closely interrelated. Heterogeneous and scattered evidence in literature remains a challenge. We searched for systematic reviews including diverse cerebrovascular events in migraineurs and reported relevant original studies to update the evidence when necessary. The studies show that migraine is associated with increased risk of transient ischemic attacks, any stroke, and possibly hemorrhagic stroke. In addition, migraine with aura increases the risk of ischemic stroke and white matter abnormalities. Migraine without aura increases the risk of cervical artery dissection as a cause of ischemic stroke. Groups with specific risk profiles are women, young people, smokers, and oral contraceptive users. The pathophysiology of the association remains uncertain. However, genetic and environmental factors may be involved in intricate mechanisms responsible for oxidative stress, vascular dysfunction and, ultimately, vascular events. In conclusion, migraine is a potential risk factor for cerebrovascular diseases. Migraineurs should be carefully evaluated considering their vascular risk assessment based on current evidence, so that healthcare professionals can provide appropriate and individualized management of other cardiovascular risk factors, notably quitting smoking and restricting use of oral contraceptives. |
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| Keywords: | migraine without aura migraine with aura cerebrovascular disorders stroke ischemic attack transient |
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