Sammanfattning
BACKGROUND: Migraine is a common neurological disease that entails a significant burden for those affected, and great health economic costs for society. Migraine is linked to a higher risk of stroke. The purpose of this article is to provide a review of the association between migraine and stroke: both ischaemic and haemorrhagic stroke, possible underlying mechanisms, clinical implications and the need for further research in this field.
METHOD: This review is based on literature searches in PubMed using a defined search string, supplemented by a pyramid search using the search engine McMaster PLUS on the words ‘migraine’ and ‘stroke’, as well as a review of the articles’ reference lists.
RESULTS: Migraine with aura is associated with a doubling of the risk of stroke, but there is no certain increased risk of stroke among persons with migraine without aura. Smoking, the use of contraceptive pills and frequent migraine attacks increase the risk. There also appears to be a somewhat higher incidence of cerebral haemorrhage among persons with migraine with and without aura.
INTERPRETATION: The association between migraine and stroke is complex. In light of the higher risk of stroke in patients with migraine with aura, it is recommended that modifiable risk factors such as smoking, hypertension and the use of contraceptive pills should be thoroughly surveyed and treated.