1
|
Yılmaz Can F. Investigation of the relationship between thrombophilic disorders and brain white matter lesions in migraine with aura. ARQUIVOS DE NEURO-PSIQUIATRIA 2024; 82:1. [PMID: 38977266 DOI: 10.1055/s-0044-1787762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/10/2024]
Abstract
BACKGROUND Migraine is associated with several genetic or acquired comorbidities. Studies conducted in recent years emphasize that the frequency of thrombophilia is high in migraine, especially migraine with aura (MA). Similarly, the presence of white matter lesions (WMLs) on brain magnetic resonance imaging (MRI) scans has been associated with migraine for many years. OBJECTIVE Based on the knowledge that both WMLs and thrombophilia variants are frequently observed in MA, we aimed to investigate whether there is a relationship between genetic thrombophilia and the presence of WMLs in these patients. METHODS The levels of proteins S and C, antithrombin III activities, activated protein C (APC) resistance, antiphospholipid immunoglobulin G/immunoglobulin M (IgG/IgM) and anticardiolipin IgG/IgM antibodies were investigated in 66 MA patients between the ages of 18 and 49 years who presented no cardiovascular risk factors. The presence of WMLs and the Fazekas grade was determined from the brain magnetic resonance imaging (MRI) scans' T2-weighted and fluid-attenuated inversion recovery (FLAIR) sequence taken from the patients. The rates of WMLs were compared in patients with and without thrombophilia. RESULTS Thrombophilia was detected in 34.8% of the patients, and 27.3% were determined to have WMLs in brain MRI scans. The WMLs were detected in 23.3% of the patients without thrombophilia, in 34.8% of those with thrombophilia, and in 50% of the subjects with multiple thrombophilia disorders. Among the thrombophilia disorders, only APC resistance was significantly more common in patients with WMLs. CONCLUSION The results of the present study showed that thrombophilia may be a mechanism that should be investigated in the etiology of increased WMLs in MA.
Collapse
Affiliation(s)
- Fatma Yılmaz Can
- Ankara Etlik City Hospital, Department of Neurology, Ankara, Turkey
| |
Collapse
|
2
|
Wang Y, Hu X, Wang X, Li L, Lou P, Liu Z. Exploring the Two-Way Link between Migraines and Venous Thromboembolism: A Bidirectional Two-Sample Mendelian Randomization Study. Thromb Haemost 2024. [PMID: 38657649 DOI: 10.1055/a-2313-0311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
BACKGROUND The objective of this study is to utilize Mendelian randomization to scrutinize the mutual causality between migraine and venous thromboembolism (VTE) thereby addressing the heterogeneity and inconsistency that were observed in prior observational studies concerning the potential interrelation of the two conditions. METHODS Employing a bidirectional Mendelian randomization approach, the study explored the link between migraine and VTE, incorporating participants of European descent from a large-scale meta-analysis. An inverse-variance weighted (IVW) regression model, with random-effects, leveraging single nucleotide polymorphisms (SNPs) as instrumental variables was utilized to endorse the mutual causality between migraine and VTE. SNP heterogeneity was evaluated using Cochran's Q-test and to account for multiple testing, correction was implemented using the intercept of the MR-Egger method, and a leave-one-out analysis. RESULTS The IVW model unveiled a statistically considerable causal link between migraine and the development of VTE (odds ratio [OR] = 96.155, 95% confidence interval [CI]: 4.342-2129.458, p = 0.004), implying that migraine poses a strong risk factor for VTE development. Conversely, both IVW and simple model outcomes indicated that VTE poses as a weaker risk factor for migraine (IVW OR = 1.002, 95% CI: 1.000-1.004, p = 0.016). The MR-Egger regression analysis denoted absence of evidence for genetic pleiotropy among the SNPs while the durability of our Mendelian randomization results was vouched by the leave-one-out sensitivity analysis. CONCLUSION The findings of this Mendelian randomization assessment provide substantiation for a reciprocal causative association between migraine and VTE within the European population.
Collapse
Affiliation(s)
- Yang Wang
- Vascular Surgery, Shandong Public Health Clinical Center, Shandong University, Jinan, China
| | - Xiaofang Hu
- Department of Neurology, Shandong Public Health Clinical Center, Shandong University, Jinan, China
| | - Xiaoqing Wang
- Interventional Department, Shandong Public Health Clinical Center, Shandong University, Jinan, China
| | - Lili Li
- Interventional Department, Shandong Public Health Clinical Center, Shandong University, Jinan, China
| | - Peng Lou
- Vascular Surgery, Shandong Public Health Clinical Center, Shandong University, Jinan, China
| | - Zhaoxuan Liu
- Vascular Surgery, Shandong First Medical University affiliated Central Hospital, Jinan, China
| |
Collapse
|
3
|
Boujenah J. Comment on the migraine and adverse pregnancy outcomes: the nuMoM2b study by Miller et al. Am J Obstet Gynecol 2022; 227:680-681. [PMID: 35679895 DOI: 10.1016/j.ajog.2022.05.068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 05/26/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Jeremy Boujenah
- Hopital diaconnesse, rue sergent Bauchat, 75012 paris; Centre médical du château, rue Louis Besquel, 94300, Vincennes.
| |
Collapse
|
4
|
Frankel LR, Medina R, Ashley M, Lopez JL, Concepion L. Status Migrainosus and Endometriosis: A Case Report and Review of the Literature. Cureus 2021; 13:e19621. [PMID: 34926079 PMCID: PMC8673682 DOI: 10.7759/cureus.19621] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/15/2021] [Indexed: 11/12/2022] Open
Abstract
Status migrainosus is a migraine complication describing an attack lasting longer than 72 hours. In this paper, we present a case of a 34-year-old female with a history of severe endometriosis and hypercoagulable factor type II disease who presented to the emergency department (ED) with a three-week history of new-onset intractable migraine with aura. Imaging findings revealed a frontal T2/FLAIR hyperintensity, venous anomaly, and bilateral optic nerve thickening. The patient was admitted for three days of inpatient treatment with improvement of her symptoms.
Collapse
Affiliation(s)
- Lexi R Frankel
- College of Allopathic Medicine, Nova Southeastern University Dr. Kiran C. Patel College of Allopathic Medicine, Davie, USA
| | - Richard Medina
- Internal Medicine, Aventura Hospital and Medical Center, Aventura, USA
| | - Michael Ashley
- Medicine, Aventura Hospital and Medical Center, Aventura, USA
| | - Jose L Lopez
- Internal Medicine, Aventura Hospital and Medical Center, Aventura, USA
| | - Livasky Concepion
- Graduate Medical Education (GME), Aventura Hospital and Medical Center, Aventura, USA
| |
Collapse
|
5
|
Maitrot-Mantelet L, Hugon-Rodin J, Vatel M, Marcellin L, Santulli P, Chapron C, Plu-Bureau G. Migraine in relation with endometriosis phenotypes: Results from a French case-control study. Cephalalgia 2019; 40:606-613. [PMID: 31810400 DOI: 10.1177/0333102419893965] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Studies have shown a significant association between migraine and endometriosis, but no study has explored the relationship between migraine and endometriosis phenotypes: Superficial peritoneal endometriosis, ovarian endometrioma, and deep infiltrating endometriosis. METHODS We conducted a case-control study using data collected from 314 women aged 18 to 42 years who had undergone surgery for benign gynecological conditions between January 2013 and December 2015. All women completed a self-administered headache questionnaire according to the IHS classification. Cases (n = 182) are women with histologically proven endometriosis and controls are women (n = 132) without endometriosis. Occurrence of migraine was studied according to endometriosis phenotypes. RESULTS Migraine prevalence in cases was significantly higher compared with controls (35.2% vs. 17.4%, p = 0.003). The risk of endometriosis was significantly higher in migrainous women (OR = 2.62; 95% CI = 1.43-4.79). When we take into account endometriosis phenotypes, the risk of ovarian endometrioma and deep infiltrating endometriosis were significant (OR = 2.78; 95% CI = 1.11-6.98 and OR = 2.51; 95% CI = 1.25-5.07, respectively). In women with endometriosis, the intensity of chronic non-cyclical pelvic pain was significantly greater for those with migraine (visual analogic scale (VAS) = 3.6 ± 2.9) compared with the women without headache (VAS = 2.3 ± 2.8, p = 0.0065). CONCLUSION Our study shows a significant association between migraine and endometriosis. In clinical practice, women of reproductive age who suffer from migraine should be screened for endometriosis criteria in order to optimise the medical and therapeutic care of this condition.
Collapse
Affiliation(s)
- Lorraine Maitrot-Mantelet
- Université Paris Descartes-Université de Paris, Sorbonne Paris Cité, Faculté de Médecine, Assistance Publique - Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre (HUPC), Centre Hospitalier Universitaire (CHU) Cochin, Department of Gynecology Obstetrics II and Reproductive Medicine, Paris, France
| | - Justine Hugon-Rodin
- Université Paris Descartes-Université de Paris, Sorbonne Paris Cité, Faculté de Médecine, Assistance Publique - Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre (HUPC), Centre Hospitalier Universitaire (CHU) Cochin, Department of Gynecology Obstetrics II and Reproductive Medicine, Paris, France.,INSERM U1153, Obstetrical, Perinatal, and Pediatric Epidemiology Research Team, the Center for Epidemiology and Statistics, Sorbonne Cité, Paris, France
| | - Magali Vatel
- Université Paris Descartes-Université de Paris, Sorbonne Paris Cité, Faculté de Médecine, Assistance Publique - Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre (HUPC), Centre Hospitalier Universitaire (CHU) Cochin, Department of Gynecology Obstetrics II and Reproductive Medicine, Paris, France
| | - Louis Marcellin
- Université Paris Descartes-Université de Paris, Sorbonne Paris Cité, Faculté de Médecine, Assistance Publique - Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre (HUPC), Centre Hospitalier Universitaire (CHU) Cochin, Department of Gynecology Obstetrics II and Reproductive Medicine, Paris, France.,Department of Development, Reproduction, and Cancer, Institut Cochin, INSERM U1016, Université Paris Descartes, Sorbonne Paris Cité, Paris, France.,Department 31: "Infection, Immunity and Inflammation", Institut Cochin, INSERM U1016, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Pietro Santulli
- Université Paris Descartes-Université de Paris, Sorbonne Paris Cité, Faculté de Médecine, Assistance Publique - Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre (HUPC), Centre Hospitalier Universitaire (CHU) Cochin, Department of Gynecology Obstetrics II and Reproductive Medicine, Paris, France.,Department of Development, Reproduction, and Cancer, Institut Cochin, INSERM U1016, Université Paris Descartes, Sorbonne Paris Cité, Paris, France.,Department 31: "Infection, Immunity and Inflammation", Institut Cochin, INSERM U1016, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Charles Chapron
- Université Paris Descartes-Université de Paris, Sorbonne Paris Cité, Faculté de Médecine, Assistance Publique - Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre (HUPC), Centre Hospitalier Universitaire (CHU) Cochin, Department of Gynecology Obstetrics II and Reproductive Medicine, Paris, France.,Department of Development, Reproduction, and Cancer, Institut Cochin, INSERM U1016, Université Paris Descartes, Sorbonne Paris Cité, Paris, France.,Department 31: "Infection, Immunity and Inflammation", Institut Cochin, INSERM U1016, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Geneviève Plu-Bureau
- Université Paris Descartes-Université de Paris, Sorbonne Paris Cité, Faculté de Médecine, Assistance Publique - Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre (HUPC), Centre Hospitalier Universitaire (CHU) Cochin, Department of Gynecology Obstetrics II and Reproductive Medicine, Paris, France.,INSERM U1153, Obstetrical, Perinatal, and Pediatric Epidemiology Research Team, the Center for Epidemiology and Statistics, Sorbonne Cité, Paris, France
| |
Collapse
|
6
|
van Os HJ, Wermer MJH, Rosendaal FR, Govers-Riemslag JW, Algra A, Siegerink BS. Intrinsic Coagulation Pathway, History of Headache, and Risk of Ischemic Stroke. Stroke 2019; 50:2181-2186. [DOI: 10.1161/strokeaha.118.023124] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background and Purpose—
Hypercoagulable states in migraine patients may play a role in the pathophysiology underlying the association between migraine and ischemic stroke. This study aims to provide more insight into the potential association of headache, ischemic stroke, and the intrinsic coagulation pathway.
Methods—
We included patients from the RATIO study (Risk of Arterial Thrombosis in Relation to Oral Contraceptives), a Dutch population-based case-control study including young women (age <50) with ischemic stroke and healthy controls. We defined a headache group based on a questionnaire on headache history. Intrinsic coagulation proteins were measured through both antigen levels (FXII, FXI, prekallikrein, HK [high molecular weight kininogen]) and protein activation, determined by measuring activated protein complex with C1esterase-inhibitor (FXIIa-C1-INH, FXIa-C1-INH, Kallikrein-C1-INH) or antitrypsin-inhibitor (FXIa-AT-INH). We calculated adjusted odds ratios and performed an interaction analysis assessing the increase in stroke risk associated with high levels of intrinsic coagulation and history of headache.
Results—
We included 113 ischemic stroke cases and 598 healthy controls. In total, 134 (19%) patients had a history of headache, of whom 38 were cases and 96 controls. The combination of headache and high intrinsic coagulation protein levels (all but FXII antigen level and both FXIa-inhibitors) was associated with an increase in ischemic stroke risk higher than was expected based on their individual effects (adjusted odds ratio FXI antigen level alone: 1.7, 95% CI, 1.0–2.9; adjusted odds ratio headache alone: 2.0, 95% CI, 1.1−3.7; combination: 5.2, 95% CI, 2.3−11.6)
Conclusions—
Headache and high intrinsic coagulation protein levels may biologically interact, increasing risk for ischemic stroke.
Collapse
Affiliation(s)
- Hendrikus J.A. van Os
- From the Department of Neurology (H.J.A.v.O., M.J.H.W.), Leiden University Medical Center, the Netherlands
| | - Marieke J. H. Wermer
- From the Department of Neurology (H.J.A.v.O., M.J.H.W.), Leiden University Medical Center, the Netherlands
| | - Frits R. Rosendaal
- Department of Epidemiology (F.R.R., B.S.S.), Leiden University Medical Center, the Netherlands
| | - José W. Govers-Riemslag
- School for Cardiovascular Diseases, Maastricht University Medical Center, the Netherlands (J.W.G.-R.)
| | - Ale Algra
- Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, and Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, the Netherlands (A.A.)
| | - Bob S. Siegerink
- Department of Epidemiology (F.R.R., B.S.S.), Leiden University Medical Center, the Netherlands
- Center for Stroke Research, Charité Universitätsmedizin, Berlin, Germany (B.S.S)
| |
Collapse
|
7
|
Levinsky Y, Zeharia A, Yacobovich J, Eidlitz-Markus T. Thrombophilia Testing in High Pediatric Migraine Risk Children With Migraine. J Child Neurol 2019; 34:121-127. [PMID: 30486734 DOI: 10.1177/0883073818811545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study sought to investigate the need for thrombophilia screening in pediatric migraineurs. The cohort included 45/824 children (5.5%) aged 3-18 years with migraine who were tested for thrombophilia at a tertiary pediatric headache clinic. Results were analyzed by background factors and indications for screening. Rates of thrombotic factors were compared with a healthy historical control group. At least 1 thrombotic factor was positive in 19/45 patients (42%). The total thrombophilia risk rate was higher in patients with aura (n = 32). Lipoprotein(a) was the factor most often abnormal in the thrombophilia group of all factors tested (8/19, 42%), regardless of migraine type or gender. It was the only factor with a significantly higher prevalence in the migraine than the historical control group. Full thrombophilia testing in migraine in pediatric headache clinics does not seem to be justified. The high prevalence of elevated lipoprotein(a) in children with migraine warrants further investigation.
Collapse
Affiliation(s)
- Yoel Levinsky
- Pediatric Headache Clinic, Day Hospitalization Department, Schneider Children's Medical Center of Israel, Petach Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Avraham Zeharia
- Pediatric Headache Clinic, Day Hospitalization Department, Schneider Children's Medical Center of Israel, Petach Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Joanne Yacobovich
- Department of Hematology-Oncology, Schneider Children's Medical Center of Israel, Petach Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tal Eidlitz-Markus
- Pediatric Headache Clinic, Day Hospitalization Department, Schneider Children's Medical Center of Israel, Petach Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| |
Collapse
|
8
|
Driul L, Londero AP. Migraine with aura and screening for biological thrombophilia. Am J Obstet Gynecol 2018; 218:364. [PMID: 29175257 DOI: 10.1016/j.ajog.2017.11.585] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Accepted: 11/17/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Lorenza Driul
- Clinic of Obstetrics and Gynecology, Univeristy Hospital of Udine, Piazzale S. Maria della Misericordia, Udine, Italy.
| | | |
Collapse
|
9
|
Kondratieva N, Azimova J, Skorobogatykh K, Sergeev A, Naumova E, Kokaeva Z, Anuchina A, Rudko O, Tabeeva G, Klimov E. Biomarkers of migraine: Part 1 – Genetic markers. J Neurol Sci 2016; 369:63-76. [DOI: 10.1016/j.jns.2016.08.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Revised: 07/18/2016] [Accepted: 08/02/2016] [Indexed: 02/05/2023]
|
10
|
Petrusic I, Podgorac A, Zidverc-Trajkovic J, Radojicic A, Jovanovic Z, Sternic N. Do interictal microembolic signals play a role in higher cortical dysfunction during migraine aura? Cephalalgia 2015; 36:561-7. [DOI: 10.1177/0333102415607191] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Accepted: 07/09/2015] [Indexed: 01/03/2023]
Abstract
Introduction The aim of this study was to evaluate the prevalence and clinical impact of interictal microembolic signals (MES) in patients suffering from migraine with higher cortical dysfunction (HCD), such as language and memory impairment, during an aura. Patients and methods This study was carried out on 34 migraineurs with language and memory impairment during aura (HCD group), 31 migraineurs with only visual or visual and somatosensory symptoms during aura (Control group I), and 34 healthy controls (Control group II). We used a Doppler instrument to detect microemboli. Demographic data, disease features and the detection of MES between these groups, as well as the predictors of HCD during the aura, were analyzed. Results The duration of aura was longer and the frequency of aura was higher among patients with language and memory impairment during aura compared to Control group I. MES was detected in 29.4% patients from the HCD group, which was significantly higher compared to 3.2% in Control group I and 5.9% in Control group II. Regarding the absence or presence of MES, demographic and aura features were not different in the HCD subgroups. A longer duration of aura, the presence of somatosensory symptoms during the aura and the presence of interictal MES were independent predictors of HCD during the aura. Conclusion The present findings indicate that HCD and MES are related in patients with migraine with aura. Further research is needed to better understand the exact pathophysiological mechanism.
Collapse
Affiliation(s)
- I Petrusic
- Faculty of Medicine, University of Belgrade, Serbia
- Department of Physiology, Faculty of Pharmacy, University of Belgrade, Serbia
| | - A Podgorac
- Faculty of Medicine, University of Belgrade, Serbia
- Institute of Mental Health, Serbia
| | - J Zidverc-Trajkovic
- Faculty of Medicine, University of Belgrade, Serbia
- Neurology Clinic, Clinical Center of Serbia, Serbia
| | - A Radojicic
- Faculty of Medicine, University of Belgrade, Serbia
- Neurology Clinic, Clinical Center of Serbia, Serbia
| | - Z Jovanovic
- Faculty of Medicine, University of Belgrade, Serbia
- Neurology Clinic, Clinical Center of Serbia, Serbia
| | - N Sternic
- Faculty of Medicine, University of Belgrade, Serbia
- Neurology Clinic, Clinical Center of Serbia, Serbia
| |
Collapse
|
11
|
Cappy H, Lucas C, Catteau-Jonard S, Robin G. Migraine et contraception. ACTA ACUST UNITED AC 2015; 43:234-41. [DOI: 10.1016/j.gyobfe.2015.01.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Accepted: 01/20/2015] [Indexed: 11/27/2022]
|
12
|
Lippi G, Mattiuzzi C, Cervellin G. Meta-analysis of factor V Leiden and prothrombin G20210A polymorphism in migraine. Blood Coagul Fibrinolysis 2015; 26:7-12. [DOI: 10.1097/mbc.0000000000000188] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
13
|
Abstract
BACKGROUND Migraine, particularly with aura, increases the risk for ischemic stroke, at least in a subset of patients. The underlying mechanisms are poorly understood and probably multifactorial. METHODS We carried out an extended literature review of experimental and clinical evidence supporting the association between migraine and ischemic stroke to identify potential mechanisms that can explain the association. RESULTS Observational, imaging and genetic evidence support a link between migraine and ischemic stroke. Based on clinical and experimental data, we propose mechanistic hypotheses to explain the link, such as microembolic triggers of migraine and enhanced sensitivity to ischemic injury in migraineurs. DISCUSSION We discuss the possible practical implications of clinical and experimental data, such as aggressive risk factor screening and management, stroke prophylaxis and specific acute stroke management in migraineurs. However, evidence from prospective clinical trials is required before modifying the practice in this patient population.
Collapse
Affiliation(s)
- Jerome Mawet
- Neurovascular Research Laboratory, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, MA, USA Emergency Headache Center, Lariboisiere Hospital, Assistance Publique-Hopitaux de Paris, France DHU NeuroVasc, France
| | - Tobias Kurth
- Inserm Research Center for Epidemiology and Biostatistics (U897), Team Neuroepidemiology, France University of Bordeaux, College of Health Sciences, France Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, MA, USA
| | - Cenk Ayata
- Neurovascular Research Laboratory, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, MA, USA Stroke Service and Neuroscience Intensive Care Unit, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, MA, USA
| |
Collapse
|
14
|
Cavestro C, Mandrino S. Thrombophilic disorders in migraine. Front Neurol 2014; 5:120. [PMID: 25071708 PMCID: PMC4090692 DOI: 10.3389/fneur.2014.00120] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2014] [Accepted: 06/25/2014] [Indexed: 01/10/2023] Open
|