Abstract
ObjectivesMigraine is a suggested risk factor for aneurysmal subarachnoid hemorrhage (aSAH). An increased risk of aSAH in migraineurs may be explained by an increased prevalence of unruptured intracranial aneurysms (UIA). We performed a case–control study to compare lifetime migraine prevalence in patients with UIA, patients with a history of transient ischemic attact (TIA) or ischemic stroke and controls without a history of aSAH, TIA or ischemic stroke.Materials and MethodsPatients with UIA were recruited from two university hospitals. Data on patients with TIA/stroke were retrieved from a previous study. Partners of patients with UIA or TIA/stroke were included as controls. Migraine history was assessed via a telephone interview based on the International Classification of Headache Disorders, second edition criteria. We calculated odds ratios (OR) for migraine with univariable and multivariable logistic regression analyses, adjusted for age, sex, hypertension and smoking.ResultsWe included 172 patients with UIA, 221 patients with TIA or stroke, and 164 controls. In UIA patients, migraine prevalence was 24.4% compared with 14.6% in controls (UIA vs. controls; OR 1.9; 95% confidence interval [CI] 1.1–3.5) and 22.2% in TIA/stroke patients (UIA vs. TIA/stroke; OR 1.1; 95% CI 0.7–1.8). After adjustments, the OR for migraine in UIA patients versus controls were 1.7 (95% CI 1.0–3.1) and 0.9 (95% CI 0.5–1.0) versus TIA/stroke. Results were comparable for migraine with and without aura.ConclusionsMigraine prevalence is possibly increased in patients with UIA compared with controls and comparable with the prevalence in patients with TIA or stroke. Further studies are needed to confirm our findings and to investigate the underlying pathophysiology.
Highlights
Migraine, especially migraine with aura, is an established risk factor for ischemic stroke (Etminan, Takkouche, Isorna, & Samii, 2005; Kurth, 2010; Schurks et al, 2009)
The large prospective of Women’s Health Study, suggested an increased risk of aneurysmal subarachnoid hemorrhage (aSAH) for women with migraine after long-term follow-up this was not statistically significant (Kurth, Kase, Schurks, Tzourio, & Buring, 2010). Another large prospective population-based cohort study from Taiwan found that migraine with and without aura were linked to an increased risk of hemorrhagic stroke (Kuo et al, 2013)
We investigated the prevalence of migraine with or without aura in patients with unruptured intracranial aneurysms (UIA) compared with patients with transient ischemic attact (TIA)/Stroke and with controls
Summary
Especially migraine with aura, is an established risk factor for ischemic stroke (Etminan, Takkouche, Isorna, & Samii, 2005; Kurth, 2010; Schurks et al, 2009). The large prospective of Women’s Health Study, suggested an increased risk of aSAH for women with migraine after long-term follow-up this was not statistically significant (Kurth, Kase, Schurks, Tzourio, & Buring, 2010). Another large prospective population-based cohort study from Taiwan found that migraine with and without aura were linked to an increased risk of hemorrhagic stroke (Kuo et al, 2013). We investigated the prevalence of migraine with or without aura in patients with unruptured intracranial aneurysms (UIA) compared with patients with TIA/Stroke and with controls
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