Association between migraine and risk of stroke: a systematic review and meta-analysis

Results regarding the association between migraine and risk of stroke are inconsistent.

A literature search of the databases (Web of Science, Google Scholar and PubMed) was made before December 2021. STATA 12.0 software was used. Odds ratios (ORs) or relative risks (RRs) and their 95% confidence intervals (CIs) regarding migraine and risk of stroke were computed.

Migraine was associated with increased risks of total stroke, ischemic stroke (IS) and haemorrhagic stroke (HS) (total stroke: OR/RR = 1.62; 95% CI: 1.44-1.83, I² = 95.8%, p < 0.001; IS: OR/RR = 1.70; 95% CI: 1.47-1.98, I² = 96.1%, p < 0.001; HS: OR/RR = 1.35; 95% CI: 1.11-1.63, I² = 85.7%, p < 0.001). Migraine with aura was related to increased risks of total stroke, IS and HS (total stroke: OR/RR = 1.95; 95% CI: 1.62-2.34, I² = 89.7%, p < 0.001; IS: OR/RR = 2.17; 95% CI: 1.78-2.64, I² = 89.2%, p < 0.001; HS: OR/RR = 1.30; 95% CI: 1.04-1.62, I² = 46.3%, p = 0.114). Migraine without aura was related to increased risks of total stroke, IS and HS (total stroke: OR/RR = 1.35; 95% CI: 1.18-1.55, I² = 85.4%, p < 0.001; IS: OR/RR = 1.34; 95% CI: 1.11-1.62, I² = 87.8%, p < 0.001; HS: OR/RR = 1.29; 95% CI: 1.04-1.61, I² = 64.8%, p = 0.023).

Migraine is associated with a higher risk of total stroke and IS. However, the association between migraine and risk of HS is with more uncertainty.