Strokes and Migraines: An Unfavourable Collaboration
Migraines are an incredibly common debilitating disease, affecting as many as 15 % of the population. Indeed, they are likely Europe’s most expensive neurological disorder, costing over € 27 billion a year in medical costs and lost productivity. However, despite it’s prevalence, the underlying causes of migraines still elude researchers.
What is understood is that migraines can occur in one of two ways: with, or without, an “aura”. An aura presents as the sensory, language, or motor disturbances that precede migraine onset for a third of migraine sufferers. These migraines have been reported to double the risk of ischemic stroke. This is not surprising, as migraines are generally considered to be a neurovascular disease, some believing that blood vessels are the most promising targets for investigation and treatment. However, what is surprising is the stark contrast to migraines without auras, which have been shown to have no impact on risk of stroke.
Researchers from the Northern Manhattan Study (NOMAS) were curious in regards to this disparity between stroke risk for sufferers of migraines with auras and without auras. Previous studies had been limited to populations of predominantly Caucasian patients; however, as Hispanics and African-Americans are at an elevated risk for stroke, researchers of NOMAS selected for an ethnically diverse group of individuals, with an average age of 71. They then used magnetic resonance imaging to detect resulting damage from “silent strokes”; strokes which do cause lasting neurological damage, but often go unnoticed. They found that individuals with a history of migraines without auras had twice the number of lesions in their brains to individuals with no history of migraines, even when controlling for other stroke risk factors. These lesions appear to be of ischemic origin, though further research needs to be carried out to confirm this.
This recent study suggests that previously perceived differences in how ischemic stroke incidence is affected by migraines with auras, to those without auras, are fallacious. Indeed, it would now seem that both double incidence, reaffirming the importance of blood vessels to migraine disease pathology. Dr. Teshamae Monteith from NOMAS commented “I do not believe migraine sufferers should worry, as the risk of ischemic stroke in people with migraine is considered small, however, those with migraine and vascular risk factors may want to pay even greater attention to lifestyle changes that can reduce stroke risk, such as exercising and eating a low-fat diet with plenty of fruits and vegetables.”
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