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Ischemic Stroke and Active Migraine
Milhaud D, Bogousslavsky J, van Melle G, Liot P.
Posted November 2002  
Neurology 2001: 57:1805-1811

Objective:  To determine the characteristics of acute ischemic stroke (IS) in patients with active migraine in a prospective stroke registry.

Results:   Of the 3,502 patients with acute IS, 130 had active migraine; 66 of these were younger than 45 years and 64 were 45 years or older. The proportion of women was significantly higher in both groups of patients with migraine than in control subjects. In young migraineurs, the posterior circulation involvement and the presence of patent foramen ovale were characteristic. In the younger migraine group, nine patients developed IS during a typical attack of migraine with aura, and 15 during migraine attack without aura in the absence of any other determined cause. In the older group, surprisingly, absence of vascular risk factors (previous hypertension, ischemic heart disease, and cigarette smoking) was characteristic.

Conclusions:   Migraine is frequent in young patients with IS and infrequent in older patients with IS. Patients with IS and migraine are mainly women with stroke features that are age dependent.