migraine with aura

4 May 2010

Migraine and Stroke in Young Adults and more

A new study suggests another major link between migraine and stroke.

The most common single cause of stroke in young adults is something called cervical artery dissection. This is a problem with one of two major arteries in your neck. When the lining of one of the arteries becomes torn, the blood can clot and weaken the wall of the artery or actually block it.

This problem can heal on its own, but it can be serious not only because of the symptoms it can cause but because it can cause stroke before it properly heals.

We know that there seems to be an increased risk of stroke for migraine patients. So the question is, is there a correlation between migraine and cervical artery dissection (CAD)?

According to a new study, yes.

The study out of Finland was written up last month. The researchers took 313 CAD patients and looked for lifetime prevalence of migraine. They also looked at migraine type and CAD type.

Both men and women with CAD were significantly more likely to have migraine disease, particularly migraine with aura.

And another interesting note. When CAD occurred, often patients reported an alleviation of migraine – another interesting link that needs to be investigated.

What we want to do is narrow down exactly why migraineurs are more likely to be stroke victims. It looks like this may be an important link. There could be, for example, a genetic factor that is causing both migraine and CAD.

The researchers concluded: Our observations suggest that patients with CAD are a significant link between ischemic stroke and migraine.

14 August 2008

Migraine with Aura: the Gene that increases Stroke Risk?

James Discoveries & Stats 0

There’s been a lot of conversation about last month’s report on a genotype known as methyleneterahydrofolate reductase, or MTHFR 677TT. If you’ve read any of the reports, you may be as confused as I was at first, but let’s take a closer look.

There has been a lot of research into the connection between stroke and migraine. People with migraine, particularly specific types of migraine, do have an increased risk of stroke, according to modern research.

Now, this study involved 4577 Caucasian women who had a history of migraine (the study as a whole actually involved over 25,000 women). Over a quarter of those presently were dealing with migraine with aura.

The study followed the women for 12 years, specifically watching for cardiovascular disease.

The interesting thing about this gene is that it actually seems to decrease the risk of migraine with aura. However, if a woman has the genetic variation, and still develops migraine with aura, the risk of stroke takes a dramatic jump.

Women with the gene and migraine with aura had over three times the risk of developing cardiovascular disease. They had four times the risk of stroke, compared to women without the gene and without migraine with aura.

It’s too early to see this as a finished picture – it’s really only another small piece in the puzzle. It doesn’t look like the gene variant itself increases stroke risk – instead, there seems to be a connection between the gene and at least one type of migraine. How this all fits together is turning out to be very complex.

So what does a woman with migraine do with this information? Should she look into genetic testing? Dr. Tobias Kurth from the Harvard Medical School and one of the authors of the study says no. "At the moment, we’re not suggesting genotyping for women with migraines with aura. The consequences [of having this gene] are completely unclear right now."

Dr. Keith Siller, director of the Comprehensive Stroke Care Center at New York University’s Langone Medical Center explains that this may not even be the "right" gene – there is a connection, but it may be another gene causing the problem.

As we try to understand the link between stroke and migraine, there are a couple of things to keep in mind. First, the increased risk from migraine alone is not a reason to panic. Second, it is a reminder that we need to pay special attention to decreasing our risk in other ways – such as paying attention to our lifestyle and what we put in our bodies.

Dr. Kurth recommends: "Doctors should try to reduce heart disease risk factors and advise young women who experience migraine with aura not to smoke and to consider birth control pill alternatives as these increase the risk of ischemic vascular problems."

And we wait until the puzzle is more complete…

For more, read Gene May Put Women With Migraine At Increased Risk Of Heart Disease And Stroke, Gene Linked To Migraine and Increased Stroke Risk, and Interrelationships among the MTHFR 677C>T polymorphism, migraine, and cardiovascular disease

14 July 2008

More on the hand-held-migraine-zapper (if you have aura)

James Discoveries & Stats, Treatments 1

Noninvasive transcranial magnetic stimulation, or TMS, continues to be a topic of conversation in the medical world. At its 50th conference, the American Headache Society listened to a positive report out of the Ohio State University about the TMS devices.

The TMS is transforming from a large device in a specialist’s office to a handheld device that can be used in the home. The hope is that the TMS can be used early in a migraine attack to stop the migraine chain reaction without drugs. Apply it to the head and turn it on, and zap the migraine away. Could it work that well?

For some migraineurs, the results seem to be encouraging. In this study, migraineurs with aura. Out of 164 patients, 39% reported being pain-free two hours after using the device. That may not sound like much, but remember that no drugs were used. And 39% is a lot better than a placebo (in this test, 22% of the placebo-using patients found similar relief).

But these were patients with aura, who used the device during the aura stage of the attack. Would patients who don’t experience aura be able to use the device with success? Time and more study will tell.

For those that have seen the headlines about the TMS device, 39% vs 22% on placebo may not live up to the hype. Still, this looks like it may be a safe, effective alternative for some people. Especially since many don’t respond or can’t even take regular migraine medication. As one of the researchers said (himself a neurologist): "Because of the lack of adverse events in this trial and the established safety of the TMS device, this is a promising treatment for migraines with aura." (Dr. Yousef Mohammad)

Read more about this preliminary study here: Electronic device zaps migraine pain, study says