Migraine is ‘vigorous player’ that underlies ischemic stroke
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Any migraine, as well as migraine with aura, demonstrated a strong association with cryptogenic ischemic stroke among adults aged 18 to 49 years, according to the results of a prospective, multicenter case-control study.

This study aimed to assess the association between migraine and cryptogenic ischemic stroke (CIS) in young adults, with subgroup analyses stratified by sex and presence of patent foramen ovale (PFO).

Investigators prospectively enrolled 347 consecutive patients aged 18-49 with a recent CIS and 347 age- and sex-matched stroke-free controls. Any migraine and migraine with (MA) and migraine without aura (MO) were identified by a screener, which we validated against a headache-neurologist. They used conditional logistic regression adjusting for age, education, hypertension, diabetes, waist-to-hip ratio, physical inactivity, current smoking, heavy drinking, and oral estrogen use to assess independent association between migraine and CIS.

-- The screener performance was excellent in patients and controls.

-- Compared with non-migraineurs, any migraine and MA were associated with CIS, whereas MO was not.

-- The association emerged both in women (OR 2.97 for any migraine, 1.61-5.47; OR 4.32 for MA, 2.16-8.65) and men (OR 2.47 for any migraine, 1.32-4.61; OR 3.61 for MA, 1.75-7.45).

-- Specifically for MA, the association with CIS remained significant irrespective of PFO.

-- MA prevalence increased with increasing magnitude of the right-to-left shunt in patients with PFO.

Conclusively, MA has a strong association with CIS in young patients, independent of vascular risk factors and presence of PFO.

Source: https://onlinelibrary.wiley.com/doi/10.1002/ana.25937