Abstract
There have been few reports concerning the characteristics of cerebral infarction associated with migraine (CIAM), and especially about the subsequent fate of these patients. We studied 14 patients (9 female) with CIAM. In all these patients the onset of cerebral infarction was accompanied by a unilateral throbbing headache, in 8 also with a gradual build-up of neurological deficits. No other cause of cerebral infarction could be found in these patients. Twelve patients had had previous attacks of migraine, with auras in 6. The nature of the neurological deficit was similar to previous auras in only 3 of these patients. The 2 patients without a history of migraine both developed migraine attacks afterwards. During the same period we also studied 14 patients (8 female) with a cerebral infarct of unknown origin (CIUO). The infarct involved the occipital lobe in 11 of the 14 patients with CIAM, whereas this occurred in 4 patients with CIUO [relative risk (RR): 2.8; 95% confidence interval (CI): 1.2–6.6]. Patients with CIAM had risk factors for atherosclerosis significantly less often than patients with CIUO (RR: 0.1; 95% CI: 0.02–0.9). The functional outcome of patients with CIAM was better than in patients with CIUO: all 14 patients with CIAM were independent in their daily activities, compared with 9 patients with CIUO (RR: 1.6; 95% CI: 1.1–2.3). No patient in either group had a recurrent stroke during a median follow-up period of 5.8 years. In conclusion. CIAM is a stroke entity causing mostly infarcts in the occipital lobe; vascular risk factors are uncommon and prognosis is generally good.
Similar content being viewed by others
References
Bamford JM, Sandercock PAG, Warlow CP, Slattery J (1989) Interobserver agreement for the assessment of handicap in stroke patients (letter). Stroke 20: 828
Bogousslavsky J, Despland PA, Regli F (1987) Spontaneous carotid dissection with acute stroke. Arch Neurol 44: 137–140
Bogousslavsky J, Regli F, Melle G van, Payot M, Uske A (1988) Migraine stroke. Neurology 38: 223–227
Broderick JP, Swanson JW (1987) Migraine-related strokes. Clinical profile and prognosis in 20 patients. Arch Neurol 44: 868–871
Buring JE, Herbert P, Romero J, Kittros A, Cook N, Manson J, Peto R, Hennekens C (1995) Migraine and the subsequent risk of stroke in the physicians' health study. Arch Neurol 52: 129–134
Featherstone HJ (1986) Clinical features of stroke in migraine: a review. Headache 26: 128–133
Fisher CM (1968) Migraine accompaniments versus arteriosclerotic ischemia. Trans Am Neurol Assoc 93: 211–213
Gorelick PB, Hier DB, Caplan LR, Langenberg P (1986) Headache in acute cerebrovascular disease. Neurology 36: 1445–1450
Headache Classification Committee of the International Headache Society (1988) Classification and diagnostic criteria for headache disorders, cranial neuralgias and facial pain. Cephalalgia 8 [Suppl 7]: 1–96
Henrich JB, Sandercock PAG, Warlow CP, Jones LN (1986) Stroke and migraine in the Oxfordshire Community Stroke Project. J Neurol 233: 257–262
Hogan MJ, Brunet DG, Ford PM, Lillicrap D (1988) Lupus anticoagulant, antiphospholipid antibodies and migraine. Can J Neurol Sci 15: 420–425
Kalendovsky Z, Austin JH (1975) “Complicated migraine”: its association with increased platelet aggregrability and abnormal plasma coagulation factors. Headache 15: 18–35
Koudstaal PJ, Gijn J van, Kappelle LJ (1991) Headache in transient or permanent cerebral ischemia. Stroke 22: 754–759
Olesen J, Friberg L, Olsen TS, Anderson AR, Lassen NA, Hansen PE, Karle A (1993) Ischaemia-induced (symptomatic) migraine attacks may be more frequent than migraine-induced ischaemic insults. Brain 116: 187–202
Olsen TS, Friberg L, Lassen NA (1987) Ischaemia may be the primary cause of the neurological deficits in classic migraine. Arch Neurol 44: 156–161
Riddle JM, D' Andrea G, Welch KM, Joseph R, McElroy HH, Grunfeld S, Christopherson TG (1989) Platelet activation and analysis of organelles in migraineurs. Headache 29: 28–33
Rothrock JR, Walicke P, Swenson MR, Lyden PD, Logan WD (1988) Migrainous stroke. Arch Neurol 45: 63–67
Rothrock J, North J, Madden K, Lyden P, Fleck P, Dittrich H (1993) Migraine and migrainous stroke: risk factors and prognosis. Neurology 43: 2473–2476
Shah AB, Coull BM, Beamer NB, Portland OR (1983) In vivo platelet activation and strokes in young adults with migraine (abstract). Neurology 33 [Suppl 2]: 206
Shuaib A (1991) Stroke from other etiologies masquerading as migraine-stroke. Stroke 22: 1068–1074
Shuaib A, Hachinski VC (1988) Migraine and the risk from angiography. Arch Neurol 45: 911–912
Stewart WF, Shechter A, Rasmussen BK (1994) Migraine prevalence. A review of population-based studies. Neurology 44 [Suppl 4]: S17-S23
Tatemichi TK, Mohr JP (1992) Migraine and stroke. In: Barnett HIM, Mohr JP, Stein BM, Yatsu FM (eds) Stroke-pathophysiology, diagnosis and management. Churchill Livingstone, New York, pp 761–785
Tourbah A, Mas JL, Baron JC, Bousser M-G (1988) Complicated migraine, migrainous infarction... or what? (letter). Headache 28: 689
Tzourio C, Tehindrazanarivelo A, Iglesias S, Alpérovitch A, Chedru F, d'Angelejan-Chatillon J, Bousser M-G (1995) Case-controle study of migraine and risk of ischaemic stroke in young women. BMJ 310: 830–833
Van Swieten JC, Koudstaal PJ, Visser MC, Schouten HJA, Gijn J van (1988) Interobserver agreement for the assessment of handicap in stroke patients. Stroke 19: 604–607
Welch KMA, Levine SR (1990) Migraine-related stroke in the context of the International Headache Society classification of head pain. Arch Neurol 47: 458–462
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Hoekstra-van Dalen, R.A.H., Cillessen, J.P.M., Kappelle, L.J. et al. Cerebral infarcts associated with migraine: Clinical features, risk factors and follow-up. J Neurol 243, 511–515 (1996). https://doi.org/10.1007/BF00886872
Received:
Revised:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00886872