TY - CHAP
T1 - Migrainous infarction
AU - Chiang, Chia Chun
AU - Chen, Shih Pin
N1 - Publisher Copyright:
© 2024 Elsevier B.V.
PY - 2024/1
Y1 - 2024/1
N2 - 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.
AB - 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.
KW - Cardioembolic stroke
KW - Endothelial dysfunction
KW - Migraine and stroke
KW - Migraine with aura
KW - Migrainous infarction
KW - Oral contraceptives
KW - Patent foramen ovale
KW - Spreading depolarization
KW - Vasospasm
UR - http://www.scopus.com/inward/record.url?scp=85183795740&partnerID=8YFLogxK
U2 - 10.1016/B978-0-12-823357-3.00021-5
DO - 10.1016/B978-0-12-823357-3.00021-5
M3 - Chapter
C2 - 38307663
AN - SCOPUS:85183795740
T3 - Handbook of Clinical Neurology
SP - 465
EP - 474
BT - Handbook of Clinical Neurology
PB - Elsevier B.V.
ER -