[Migraine-infarct in patients treated with beta-blockers]

Migraine in itself is a potential cause of cerebral infarct in young adults. However the mechanism of migrainous ictus is open to discussion. Some drugs (oral anticonceptives, ergotaminics) could favor its appearance. Three cases has described in the medical literature of migraine patients in whom betablockers administration has been related with onset of an ischemic ictus. We present two new cases of this association. Nonselective betablockers provoke an increase in platelet activity by stimulation of platelet alpha-2 receptors; this together with their vasoconstrictor effect could favor the apparition of cerebral infarction in patients with migraine. We suggest, following other authors, to include non selective betablockers in the group of drugs which have to be carefully managed in the patients with migraine, especially in those with the classical type (migraine with aura) in whom an initial vasoconstriction has been suggested.