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Migraine in Young Stroke Patients-Better Outcomes Despite Distinct Risk Profiles: Insights From the STROKE-CARD-Study
Katharina Kaltseis1, Silvia Felicetti1,2, Benjamin Dejakum1,2
1Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria.
European Journal of Neurology
|August 6, 2026
Summary
Migraine, particularly with aura, is linked to younger stroke onset and patent foramen ovale in young adults. Despite similar stroke patterns, migraine patients showed better short-term recovery.
Area of Science:
- Neurology
- Cardiology
- Epidemiology
Background:
- Migraine is a neurological disorder and a non-traditional risk factor for ischemic stroke.
- The relationship between migraine subtypes and stroke outcomes in young adults is not well understood.
Purpose of the Study:
- To evaluate the association between migraine (with and without aura) and stroke etiology, functional outcomes, and cardiovascular risk in young ischemic stroke patients.
Main Methods:
- Young stroke patients (≤55 years) from the STROKE-CARD study were interviewed by headache specialists using ICHD-3 criteria.
- Demographic, clinical, neuroimaging, etiological, and cardiovascular risk data were collected.
Main Results:
- Of 289 patients, 92 (31.8%) had a history of migraine (51.1% with aura). Migraine was more common in women and associated with younger age at stroke onset.
- Patent foramen ovale (PFO) was more prevalent in migraine with aura patients (68.9% vs. 36.9%).
- Migraineurs had more favorable stroke severity (NIHSS) and functional outcomes (mRS) at discharge. Migraine without aura independently predicted good functional outcome (OR 7.21).
Conclusions:
- In young adults with ischemic stroke, migraine (especially with aura) is linked to younger onset and higher PFO prevalence.
- Traditional vascular risk factors and stroke characteristics were similar across groups.
- Migraine patients experienced more favorable short-term outcomes despite comparable stroke patterns.
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