Migraine improvement after spontaneous cervical artery dissection the Italian Project on Stroke in Young Adults (IPSYS)
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Whether migraine modifies after spontaneous cervical artery dissection (sCeAD) more than after other stroke etiologic subtypes has never been adequately investigated.
In the setting of the Italian Project on Stroke in Young Adults (IPSYS), we compared the course of migraine before and after acute brain infarct in a group of migraine patients with sCeAD and a group of migraine patients whose ischemia was due to a cause other than CeAD (non-CeAD IS), matched by sex, age (± 3 years), and migraine subtype.We applied linear mixed models to evaluate pre-event vs post-event changes and differences between sCeAD and non-CeAD IS patients.
Eighty-seven patients per group (migraine without aura/migraine with aura, 67/20) qualified for the analysis. After the acute event, migraine headaches disappeared in 14.0% of CeAD patients vs 0.0% of non-CeAD IS patients (p ≤ 0.001). Migraine frequency (patients suffering at least 1 attack, from 93.1 to 80.5%, p = 0.001), pain intensity (from 6.7 ± 1.7 to 4.6 ± 2.6 in a 0 to 10 pain scale, p ≤ 0.001), and use of acute anti-migraine medications (patients taking at least 1 preparation, from 81.6 to 64.4%, p = 0.007) also improved significantly after CeAD as opposed to that observed after non-CeAD IS.
The spontaneous improvement of migraine after sCeAD reinforces the hypothesis of a pathogenic link between the two conditions.
KeywordsCervical artery dissection Stroke in young adults Migraine
Valeria De Giuli: manuscript drafting/revising, study design, data analysis and interpretation, and data acquisition. All authors: manuscript drafting/revising and data acquisition. Francesca Graziano, Mario Grassi, and Alessandro Pezzini: statistical analysis. Alessandro Pezzini: manuscript drafting/revising, study design, data analysis and interpretation, data acquisition, statistical analysis, and study supervision.
The Italian Project on Stroke in Young Adults (IPSYS) is supported by a grant from the Associazione per la Lotta alla Trombosi e alle Malattie Cardiovascolari (ALT).
Compliance with ethical standards
All aspects of the study were approved by the Ethics Committee of the coordinating Center (University of Brescia) and then of each study site. Written informed consent was obtained from all patients (or next of kin).
Role of the sponsor
The sponsor had no role in the design and conduct of the study; the collection, management, analysis, and interpretation of the data; the preparation, review or approval of the manuscript; or the decision to submit the manuscript for publication.
Alessandro Pezzini had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
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