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Stroke in patients with migraine
Authors:Jacques De Reuck  Koen Paemeleire  Georges Van Maele
Institution:1. Service of Radiology, University Hospital Central de Asturias and Ineuropa, Oviedo, Spain;2. Neuroscience Area, Service of Neurology, University Hospital Central de Asturias and Ineuropa, Oviedo, Spain
Abstract:Background and purposeMigraine with aura (MA) is considered as a risk factor for ischaemic stroke. The present observational retrospective study compares migraine patients admitted for a documented stroke with those presenting focal neurological symptoms and headache without a demonstrable lesion and in which the final diagnosis was a migraine attack with aura.Material and methodsThe study included 14 migraine patients with a stroke and 37 without a stroke. The clinical characteristics, the vascular risk factors and the results of the technical examinations were compared.ResultsStroke occurred in migraine patients with aura as well as without aura. Classical vascular risk factors were rather rare. Patent foramen ovale (PFO) with or without atrial septum aneurysm appeared to be the main risk factor for stroke in patients with a history of migraine. Infarcts were mainly located in the supratentorial territory of the posterior cerebral circulation. Also some lobar haematomas were observed, but their aetiology remained uncertain. The strokes were generally mildly severe with good outcome. Hyperintense signals in the cerebral white matter and cerebellum, on T2-weighted magnetic resonance imaging, were more frequent in the migraine patients with stroke.ConclusionsThe presence of PFO, rather than of MA, appeared to be the main risk factor for stroke patients with migraine. No direct relation between migraine and stroke could be demonstrated.
Keywords:migraine with aura  migraine without aura  posterior circulation infarct  lobar haematoma  patent foramen ovale  cerebral white matter changes  migrena z aur?  migrena bez aury  zawa? w tylnym kr?gu unaczynienia  krwiak p?atowy  dro?ny otwór owalny  zmiany w istocie bia?ej mózgu
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