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Migrainous stroke
J F Rothrock1, P Walicke, M R Swenson
1Department of Neurosciences, University of California Medical Center at San Diego 92103.
Archives of Neurology
|January 1, 1988
Summary
Migraine-associated stroke affects mostly women and may involve vasospasm. Imaging confirmed stroke in over half of patients, with arteriography showing abnormalities in some cases.
Area of Science:
- Neurology
- Vascular Neurology
- Neuroimaging
Background:
- Migraine is a common neurological disorder.
- Migraine-associated stroke is a rare but serious complication.
- Understanding the pathophysiology of migraine-associated stroke is crucial for diagnosis and treatment.
Observation:
- A prospective study evaluated 22 patients with acute migraine-associated stroke.
- The study group comprised 91% females, with 23% having a history of migrainous stroke.
- Standard stroke risk factors and mitral valve prolapse were not more prevalent than in the general population.
Findings:
- Brain imaging (CT, MRI, or radionuclide scan) detected ischemic or hemorrhagic infarction in 55% of patients.
- Cerebral arteriography revealed stroke-related abnormalities in 42% of cases, with a higher incidence (67%) when performed within 72 hours of stroke onset.
- Extracranial and/or intracranial vasospasm is implicated as a potential major factor in some cases of migrainous stroke.
Implications:
- Migraine-associated stroke may result from various mechanisms, with vasospasm being a significant contributor.
- Neuroimaging and cerebral arteriography are valuable diagnostic tools.
- Further research is needed to elucidate the precise mechanisms and optimize management strategies for this condition.