History of migraine and risk of cerebral ischaemia in young adults. The Italian National Research Council Study Group on Stroke in the Young.

Institute of Neurology, Department of Internal Medicine and Public Health, University of L'Aquila, L'Aquila-Collemaggio, Italy.

BACKGROUND: A history of migraine has been proposed as a risk factor for cerebral ischaemia in women under 45. METHODS: To investigate the association between history of migraine and cerebral ischaemia, we performed a case-control study of 308 patients aged 15-44, with either transient ischaemic attack (TIA) or stroke, and of 591 age- and sex-matched controls prospectively recruited in seven university hospitals. Crude and adjusted odds ratios were calculated using logistic regression analysis. FINDINGS: A history of migraine was more frequent in patients than in controls (14.9% vs 9.1%; adjusted odds ratio 1.9, 95% confidence interval 1.1-3.1). In the prospectively designed subgroup analyses, a history of migraine reached the highest odds ratio (3.7, 95% CI 1.5-9) and was the only significant risk factor in women below age 35 (p=0.003); atherogenic risk factors were more relevant in men and in patients older than 35; previous migraine attacks with aura were more frequent in stroke patients (odds ratio 8.6, 95% CI 1-75). INTERPRETATION: Our findings indicated that the rare association between migraine and cerebral ischaemia is limited to women below age 35, and suggest a need for careful clinical evaluation of comorbidity in the presence of migraine with aura.

PMID: 8684100 [PubMed - indexed for MEDLINE]