Source: Brachytherapy  |  Posted 7 years ago

By Paula Moyer

NEW ORLEANS, LA -- February 8, 2005 -- Migraine may only increase the risk of stroke if it is accompanied by certain types of visual aura, according to investigators who presented their findings here at the 30[^]th[] annual International Stroke Conference.

The findings confirmed that "migraine with aura is associated with increased of ischemic stroke in young women," said primary investigator Steven Kittner, MD. The focus of their study was young women and their risk of ischemic stroke. More specifically, Dr. Kittner and his co-investigators found that visual loss may be more predictive of stroke than the spots, lines, and waves that are often experienced in migraine with aura. Dr. Kittner is a researcher at the Baltimore Veterans Affairs Medical Center, where he is a professor of neurology at the University of Maryland School of Medicine.

The investigators conducted the study because, although the association between ischemic stroke and migraine had been observed, they wanted to know the specific aura symptoms that increased the risk.

They reviewed the data from the Stroke Prevention in Young Women Study, which involved 963 women in a population-based study in which 542 stroke cases were matched to 421 controls. The enrollees were 15 to 49 years old. The investigators used a modified version of the International Headache Society (IHS) definition of migraine, because the complete elements of the IHS migraine criteria were not available. Therefore, the investigators defined an individual as having migraine without aura if she had no history of aura; experienced nausea, vomiting or sensitivity to light during a headache; and had such headaches at least 5 times per year. A participant was defined as having migraine with aura if she had ever seen spots, lines, flashing lights, or vision loss around the time of the headache, and had such headaches at least 2 times per year or more.

Compared to women with no migraine, women who had migraine with some type of visual loss were 2.4 times as likely to have stroke. Women who saw spots and lines were 1.4 times as likely to have a stroke. When the women were grouped by type of visual phenomenon, those with migraine no positive symptoms, such as flashing lights, had a 1.6 odds ratio, and those with no visual loss had a 1.5 odds ratio.

Dr. Kittner stressed that the young women's risk of stroke is still quite low, but added that for women who have migraine with aura, there may be even more benefits to reducing their overall risk for stroke.

Overall, the women who had had stroke were more likely to have hypertension and diabetes, and were more likely to smoke (P <.05 for all). Women with migraine were more likely to be obese (P <.05). Odds ratios for stroke risk compared to reference group without migraine are shown below.

[Presentation title: Type of Migraine Aura Symptoms Determines Association With Ischemic Stroke: The Stroke Prevention in Young Women Study, February 3, 2005. Abstract #P320]