Two young patients with stroke in conjunction with migraineus headache.

Abstract

In adults, migraine with aura is considered to be a risk factor for stroke, especially when other risk factors exist. However, the relationship between migraine with aura and risk of cerebral infarct in children has not been well established and requires further study. We describe four young patients who suffered from migraine with aura and focal neurological deficits. All four patients had migraine with aura and focal neurological deficits associated with headaches. Two of the four young patients had cerebral infarct during their migraine headaches. Detailed investigation did not reveal the etiology of the cerebral infarct in these two adolescents. No risk factor for stroke was apparent in any of the four patients and no specific risk factor or reliable clinical feature could be used to identify these young patients at risk for irreversible cerebral ischemia. Thus, our observations provide support that there may be an association between migraine with aura and risk of stroke in children. We, therefore, advocate aggressive treatment using prophylactic agents to prevent migraine attacks in children suffering from migraine with aura, especially when auras are prolonged.