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Migraine with Aura May Signal Increased Stroke Risk
ST. PAUL, MN -- People who have migraine headaches accompanied by sensations of lights, voices or numbness, commonly known as auras, may have an increased stroke risk, according to a study in the May issue of Neurology, the scientific journal of the American Academy of Neurology.
Research suggests that almost 50 percent of people who have migraine headaches with aura also have a condition known as patent foramen ovale, a congenital opening between two chambers in the heart. The opening is present in almost one-third of the general public and is a known risk factor for the uncommon strokes that occur in young people.
"We hope our results can help educate migraine patients who may have a heightened risk for stroke," said neurologist and study author Gian Paolo Anzola, MD, of the University of Brescia in Brescia, Italy. "By educating these people about ways to lower their stroke risk, we hope to reduce the number of strokes."
In the study, researchers compared 113 people who have migraines with aura to 53 people who have migraines without aura and 25 people without migraine headaches. Study participants were an average age of 34. To detect patent foramen ovale, participants were given intravenous saline solution that was shaken to produce bubbles. Researchers then monitored the solution by ultrasound as it passed through blood vessels.
In only those with patent foramen ovale, microbubbles from the saline solution flowed through the opening and moved into blood vessels within the brain. Clots which form in the veins can also pass through a patent foramen ovale, enter brain arteries and cause a stroke. Such clots are trapped in the lungs of those without the disorder; they are harmless if the clots are small, but can cause lung damage if the clots are large.
Overall, researchers state that people who have migraine with aura have a very low risk of stroke, but it is three times greater than patients with migraine alone and up to eight times greater than those who do not experience migraine headaches.
To lower stroke risk, researchers suggest that all patients develop an active relationship with a neurologist. "A neurologist can help identify ways to help lower a patient's stroke risk," said Anzola. "In addition, I recommend no smoking for those who have migraines accompanied by aura, as well as no use of birth control pills for women with these migraines."
The American Academy of Neurology, an association of more than 15,000 neurologists and neuroscience professionals, is dedicated to improving patient care through education and research.
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