Migraine and risk of ischaemic stroke: A case-control study

Abstract

Objectives - To determine whether migraine is a risk factor for ischaemic stroke. Design - A case-control study. Setting - Two hospitals in Paris. Subjects - 212 patients with stroke (137 men and 75 women) and 212 controls matched for sex, age (to within five years), and history of hypertension. Main outcome measures - Ischaemic stroke, confirmed by brain computed tomography or magnetic resonance imaging, and history of headache, recorded with structured questionnaire during interview. Results - Prevalence of migraine did not differ between patients with stroke and controls: 18/137 v 17/137 for men (odds ratio 1·1 (95% confidence interval 0·5 to 2·2), p=0·86); 23/75 v 17/75 for women (odds ratio 1·6 (0·7 to 3·5), p= 0·24); and 41/212 v 34/ 212 for both sexes (odds ratio 1·3 (0·8 to 2·3), p= 0·33). When subjects were split into two age groups, however, prevalence of migraine was significantly higher among younger women (aged <45) with stroke compared with their controls (13/20 v 6/20, odds ratio 4·3 (1·2 to 16·3), p=0·03). Furthermore, the risk of ischaemic stroke was higher among younger women who smoked (7/20 v 1/20, odds ratio 10·2 (1·1 to 93·3)). Conclusions - Prevalence of migraine was not different between patients with stroke and matched controls except among women aged <45, when migraine and stroke were significantly associated.