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Literature highlights
I suffer from migraine: am I going to have a stroke?
Headache and migraine are considered risk factors for cerebrovascular disorders, such as stroke. Most data are derived from retrospective case-control studies, because few prospective investigations have been conducted so far on this subject. This survey was carried out in a sample of 39,754 U.S. female health workers, aged 45 or older, who participated in the Women?s Health Study and were followed up prospectively for an average period of 9 years. Stroke occurrence was determined from the patients? reports and was confirmed by a review of their clinical records, if available. A total of 385 cases of stroke (including 309 with ischaemic stroke, 72 with haemorrhagic stroke and 4 with stroke of undetermined origin) were thus identified. No increase in stroke risk was found when patients suffering from migraine in general or migraine without aura were compared with non-migraineurs. By contrast, women suffering from migraine with aura were half again as likely to have a stroke, particularly an ischemic stroke, while showing no increased risk fort haemorrhagic stroke. The risk of stroke in general and of ischaemic stroke in particular was higher in patients who had migraine with aura and were younger than 55. Patients with headache in general, or with non-migraine headache, did not have a higher risk for cerebrovascular disorders (stroke in general and the ischaemic and haemorrhagic stroke subtypes). Based on the results of this survey, it can be assumed that migraine in general is not associated with an increased tendency to develop cerebrovascular disorders. An analysis by patient subgroup shows that only patients with migraine with aura have a slightly higher risk of having a stroke, particularly of the ischaemic type. However, it should be noted that, even in patients suffering from migraine with aura, the absolute risk of stroke is rather low, with an increase of 3.8 new cases per ten thousand women a year compared with non-sufferers.
Migraine, headache, and the risk of stroke in women: a prospective study
Kurth T, Slomke MA, Kase CS, Cook NR, Lee IM, Gaziano JM, Diener HC, Buring JE.
Neurology 2005;64:1020-6
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