PHILADELPHIA – Migraine with aura seems to be a risk factor for cervical artery dissection, Dr. Ville Artto concluded in a poster presented at the International Headache Congress.
His study of 626 subjects found that migraine and migraine with aura were significantly more common in men and women who had experienced a cervical artery dissection than in controls.
The pathophysiologic link between migraine and cervical artery dissection remains unclear, Dr. Artto said. More than 60% of the cases who had active migraines at the time of their dissections, however, reported that their migraines were alleviated after the incident.
Patients with migraine and cervical artery dissection may represent a link between ischemic stroke and migraine, wrote Dr. Artto of the Helsinki (Finland) University Central Hospital. “This connection may represent common pathophysiological or genetic background, or both.”
The study included 313 patients, mean age 46 years, with cervical artery dissection and 313 age-matched controls. Cases were significantly more likely to smoke than were controls (37% vs. 23%) and female cases were significantly more likely than female controls to be using oral contraceptives (36% vs. 25%).
Migraine was present in 36% of cases and in 23% of controls. Migraine with aura was present in 23% of cases and 12% of controls. Both differences were significant. In women, migraine was present in 54% of cases and 35% of controls; migraine with aura was present in 35% of cases and 18% of controls. Among males, migraine was present in 27% cases and in 16% of controls; migraine with aura was present in 16% of cases and 0.4% of controls.
When the investigators compared the characteristics of the dissection between cases with and without migraines, they found similar rates of vertebrobasilar dissection, bilateral dissection, occlusion, and intracranial dissection. The National Institutes of Health Stroke Scale score was not different at onset (3 in migraineurs and 4 in nonmigraineurs). The Rankin score was similar at 3 months (1 in both groups). The rate of ischemic stroke was 68% in migraineurs and 73% in nonmigraineurs–not a significant difference.
The International Headache Society and the American Headache Society sponsored the congress. Dr. Artto report no potential conflicts of interest.