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(Stroke. 2007;38:2407.)
© 2007 American Heart Association, Inc.

Editorials

Migraine With Aura and Ischemic Stroke

Which Additional Factors Matter?

Tobias Kurth, MD, ScD

From the Divisions of Aging and Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School; and the Department of Epidemiology, Harvard School of Public Health, all in Boston, Mass.

Correspondence to Tobias Kurth, MD, ScD, Division of Preventive Medicine, Brigham and Women’s Hospital, 900 Commonwealth Ave East, 3rd Floor, Boston, MA 02215-1204. E-mail tkurth@rics.bwh.harvard.edu

Key Words: cerebral infarct • migraine • smoking • stroke

An extract of the first 250 words of the full text is provided, because this article has no abstract.

See related article, pages 2438–2445.

Migraine with aura has been consistently associated with increased risk of ischemic stroke.^1–3 Most studies suggest that this association is particularly strong for younger women. Although several potential biological mechanisms have been proposed to explain the migraine-stroke association, the precise mechanisms remain unknown. Because migraine is particularly prevalent in an age group in which ischemic stroke, even among migraineurs with aura, is very rare, it seems likely that factors in addition to migraine with aura must be present to lead to an increased risk of stroke.

In this issue of Stroke, MacClellan and colleagues⁴ evaluate several additional features that may help to identify patients with migraine with aura who are at particular increased risk of ischemic stroke. In this population-based case-control study of 386 women aged 15 to 49 with a first- ever ischemic stroke event and 614 age and ethnicity-matched controls, migraine and visual aura symptoms were ascertained using a standardized headache questionnaire. Participants could be classified into patients with probable migraine with visual aura (PMVA), probable migraine without visual aura, and patients without migraine. Compared with nonmigraineurs, women with PMVA had increased risk of ischemic stroke (odds ratio 1.5; 95% CI, 1.1 to 2.0). This association attenuated slightly when adjusting for potential stroke risk factors. Consistent with many other studies, migraineurs without aura were not at increased risk of ischemic stroke.

Before discussing additional factors that may increase this observed risk, some methodological considerations should be taken into account when interpreting . . . [Full Text of this Article]

Related Article:

Probable Migraine With Visual Aura and Risk of Ischemic Stroke: The Stroke Prevention in Young Women Study

Leah R. MacClellan, Wayne Giles, John Cole, Marcella Wozniak, Barney Stern, Braxton D. Mitchell, and Steven J. Kittner
Stroke 2007 38: 2438-2445. [Abstract] [Full Text] [PDF]

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