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Migraine and the risks from angiography
1Department of Clinical Neurological Sciences, University Hospital, London, Ontario, Canada.
Abstract:
There is some suggestion in the literature that patients with migraine may be at an increased risk for developing complications as a result of cerebral angiography. To assess this risk, we reviewed the charts of 142 patients with migraine. A total of 149 angiograms were performed for acute headache (55), new focal symptoms (40), exertional (including coital) headaches (nine), hemiplegic migraine (three), ophthalmoplegic migraine (five), vertebrobasilar migraine (six), migraine accompaniments (three), and other causes (14). Transient events were seen in six patients and these were transient amnesia (one), hemisensory changes (two), hemiparesis (one), global confusion (one), and angina (one). One patient with a history of severe ischemic heart disease developed a myocardial infarction two hours after angiography. Focal cerebral events occurred in 2.6% of cases. This compares with a rate of complications of 2.8% caused by angiography in a prospective study of 1002 patients from our center. According to our findings, it appears that a history of migraine does not increase the risk of complications caused by angiography. Angiography during episodes of acute headaches would also appear to be a safe procedure. Transient focal neurologic symptoms, however, are not infrequent, especially in cases of classic migraine.
Insights
Patients with migraine do not face increased risks from cerebral angiography. This study found complication rates similar to the general population, indicating angiography is safe for migraineurs, even during acute headaches.
Area of Science:
- Neurology
- Radiology
- Vascular Imaging
Background:
- Migraine patients may have a higher risk of complications from cerebral angiography.
- Previous literature suggests a potential link between migraine and adverse events post-angiography.
Purpose of the Study:
- To evaluate the risk of complications associated with cerebral angiography in patients with a history of migraine.
- To determine if migraineurs experience a higher complication rate compared to the general population undergoing angiography.
Main Methods:
- Retrospective chart review of 142 patients with migraine who underwent 149 angiograms.
- Analysis of complication rates, including transient and focal cerebral events.
- Comparison of complication rates with a prospective study of 1002 patients.
Main Results:
- Focal cerebral events occurred in 2.6% of migraine patients.
- Overall complication rate (2.6%) was comparable to the general population (2.8%).
- Transient neurologic symptoms were observed, particularly in classic migraine cases.
Conclusions:
- A history of migraine does not appear to increase the risk of complications from cerebral angiography.
- Cerebral angiography is a safe procedure for patients with migraine, including during acute headache episodes.
- Transient focal neurologic symptoms can occur, especially in classic migraine.