France: Study on Migraine with Aura and Cryptogenic Stroke

Young adults having migraine with aura and cryptogenic stroke should be evaluated for atrial fibrillation, suggests a recent study in the journal Cephalalgia. According to the study, in patients with migraine with aura, atrial fibrillation was a common cause of ischemic stroke.

Migraine patients are at an increased risk of ischemic stroke. The association is stronger in those having migraine with aura compared to those without aura, in women than in men, and in younger subjects. However, there is still ongoing debate on the mechanisms by which migraine might increase ischemic stroke risk. Considering this, Cédric Gollion, University of Toulouse, Toulouse, France, and colleagues analysed the associations between migraine with aura and migraine without aura and the causes of ischemic stroke in patients aged 18–54 years treated consecutively in a university hospital stroke center.

The study included a total of 339 patients. Migraine with aura was diagnosed in 58 patients, and migraine without aura in 54 patients.

Key Findings of the Study

• Patients with migraine with aura were younger and had fewer traditional cardiovascular risk factors than patients with no migraine.
• Migraine with aura was strongly associated with atrial fibrillation (odds ratio, 5.08) and negatively associated with atherosclerosis (odds ratio, 0.29) and small vessel disease (odds ratio, 0.13).
• No other cause of stroke was significantly associated with migraine.
• The most common cause of stroke was atherosclerosis in no-migraine patients, dissection in migraine without aura patients, and patent foramen ovale in migraine with aura patients.
• Atrial fibrillation was, together with dissection, the second leading cause of stroke in migraine with aura patients, accounting for 10.34% of cases in this subgroup.

"We showed that atrial fibrillation was a common cause of ischemic stroke in young adults with migraine with aura," concluded the authors.

The study, "Atrial fibrillation and migraine with aura in young adults with ischemic stroke," is published in the journal Cephalalgia.

DOI: https://journals.sagepub.com/doi/10.1177/0333102420970880