Wednesday, December 05, 2007

More on the Migraine-Stroke Link

Migraine Might Bring More Than Meets the Eye
Posted 11/27/2007

Marian C. Limacher, MD

Migraine with visual aura was associated with stroke risk in young women.

Migraine has long been recognized as a risk factor for stroke. To clarify this relation, researchers conducted a case-control analysis using data from the Stroke Prevention in Young Women Study; 386 women (age range, 15-49) who had experienced ischemic stroke were compared with 614 matched controls. Women were classified as having no migraine history, having probable migraine without visual aura, or having probable migraine with visual aura (PMVA); visual aura was defined as "seeing spots, lines, or flashing lights around the time of probable migraine, or ever experiencing loss of vision."

A total of 145 ischemic strokes were identified in women who had PMVA, yielding a 50% greater likelihood of stroke compared with that in women who did not have migraine. However, probable migraine without visual aura was not associated with likelihood of stroke. PMVA significantly increased the risk for stroke in women without a history of hypertension, diabetes, or myocardial infarction. The minimally adjusted risk for stroke of undetermined cause in women with PMVA was 1.6 (95% confidence interval, 1.1-2.3), but other stroke subtypes (large-artery atherosclerotic, cardioembolic, and lacunar) were not significantly associated with prior PMVA.

In an adjusted analysis, neither smoking nor oral contraceptive (OC) use had independent effects on the association between PMVA history and incident stroke. However, women with PMVA who smoked and used OCs had sevenfold higher odds of stroke (95% CI, 1.4-22.8) compared with women with PMVA who did not smoke and use OCs. Among the few women reporting a first PMVA within 12 months of stroke or of study enrollment, the odds ratio for stroke was 6.0 (95% CI, 1.9-18.6).

The results of this population-based study confirm a substantial risk for stroke in young women who use OCs and smoke, especially for women with PMVA. The suggestion that new-onset PMVA is associated with stroke within the first year bears further study and could call for heightened assessment and standardized screening for this form of migraine.

— Marian C. Limacher, MD

It sure does make you stop and think now, doesn't it! I must say this; in the worst of my absolute worst migraine attacks, my fear has always been exactly this right here. Why? Because of a previous tia. At the age of 37. 37!! I do NOT smoke. Nor do I use OCs.

At the time, I had(over) used the injectable type of triptan, as prescibed, by an unknowing doctor (that I no longer use) THANK YOU TERI!, anyway - educate yourself with your medication. With your physician. Pharmacy. What you put in your body, who you trust to take care of you. It really does matter.

You wouldn't let someone put sugar in your gas tank right? Are you treating your body with the same regard?

May you have a healthy, and pain-free day


Migraine Chick said...

I'm not smoking or using OC's either, but this whole aura associated to stroke thing still really scares me.

deborah said...

unfortunately - it should

Lisa Milton said...

Did you just say you had a TIA at 37!?

I just shuddered a bit.

That's a scary study.

deborah said...

yes, Ma'am. terrifying isn't it!

Scribbit said...

I had never heard of this connection before--wow. Scary.

swibber said...

I am 23 yeras old and used OCs for just one month before having a TIA. I suffer from migraines with aura and have now had 2 TIAs, 1 month apart, despite discontinuing OCs and never smoking.

deborah said...

Wow, Swibber; I am sorry for your misfortune. It is truly a very scary disease we are fighting. Best of luck to you.

Anonymous said...

I have had migraines for over 25 years, used many prescription drugs and have in fact had a stroke in my left eye. It has left me with very blurry vision in the lower portion of that eye. Nothing can be done for it and whenever I have a whopper of a migraine, it causes my eye to be so blurry that I can barely see out of it. I have never had auras in my eyes but in my ears; so go figure!!