Migraine and stroke

Abstract

We reviewed the literature concerning the relationship between migraine and ischemic stroke, and compared our data with reported findings. The incidence of migrainous stroke, strictly defined according to the International Classification of Headache 3 beta version, is quite low. A European MRI study indicated that the relative risk of ischemic stroke is increased two-fold in migraine patients with aura, and white matter lesions are located predominantly in the posterior circulation region. The risk of ischemic stroke in patients with migraine aura under 45 years old was reduced to the control level in the group that avoided oral contraceptives and quit smoking. Migraine is a relatively low risk factor for ischemic stroke, in contrast to classic risk factors for stroke, such as hypertension, diabetes mellitus, and atrial fibrillation. Our data concerning the location of white matter lesions showed predominance in the anterior circulation region, in marked contrast to the European study. The reason for this difference remains unknown. It is possible that the white matter lesions in some migraine patients could be caused by reversible vasoconstriction syndrome.