Migrainous infarction

Chia Chun Chiang*, Shih Pin Chen

*Corresponding author for this work

Research output: Chapter in Book/Report/Conference proceedingChapterpeer-review

Abstract

Migrainous infarction is defined as a migraine attack occurring as migraine with aura, typical of the patient's previous attacks, except that one or more aura symptoms persist for >60 min, and neuroimaging demonstrates ischemic infarct in the relevant area. To better understand migrainous infarction, one must disentangle the complex interactions between migraine and stroke. In this chapter, we first discuss the migraine–stroke association in sections including “Increased Risks of Stroke and Subclinical Infarcts in Patients With Migraine,” “Migrainous Headache Cooccurring or Triggered by Ischemic Stroke,” “Stroke Progression in Patients With Migraine,” and “Clinic Conditions Associated With Higher Risks of Both Migraine and Stroke.” As an extreme example of migraine–stroke association, the annual incidence of migrainous infarction was reported to be 0.80/100,000/year, with the incidence in females nearly twofold that of male patients. Patients diagnosed with migrainous infarction are typically younger (average age 29–39 in case series), have fewer traditional vascular risk factors, and have more favorable prognosis compared to strokes from traditional risk factors. Thorough evaluation is recommended to rule out other etiologies of stroke. Patients diagnosed with migrainous infarction should receive antiplatelet therapy and migraine preventive therapy to avoid future events. Vasoactive medications, including triptans and ergots, should be avoided.

Original languageEnglish
Title of host publicationHandbook of Clinical Neurology
PublisherElsevier B.V.
Pages465-474
Number of pages10
DOIs
StatePublished - Jan 2024

Publication series

NameHandbook of Clinical Neurology
Volume199
ISSN (Print)0072-9752
ISSN (Electronic)2212-4152

Keywords

  • Cardioembolic stroke
  • Endothelial dysfunction
  • Migraine and stroke
  • Migraine with aura
  • Migrainous infarction
  • Oral contraceptives
  • Patent foramen ovale
  • Spreading depolarization
  • Vasospasm

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