Changes in Migraine Symptoms after Ischemic Stroke: A Cohort Study.

IF 2.2 3区医学 Q3 CLINICAL NEUROLOGY Cerebrovascular Diseases Pub Date : 2024-05-23 DOI:10.1159/000539421

Nelleke van der Weerd, Nadine Pelzer, Emma Egberts, Marit Mertens, Willemijn Bakker, Katie M Linstra, Arn M J M van den Maagdenberg, Erik W van Zwet, Antoinette MaassenVanDenBrink, Gisela M Terwindt, Marieke J H Wermer

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Abstract

Introduction: Migraine symptoms are postulated to improve post-stroke. We aimed to determine post-stroke changes in patients with active migraine pre-stroke and explored the relation with stroke location and stroke-preventive medication use.

Methods: Patients with active migraine who had an ischemic stroke were retrieved from three research-cohorts between 2014 and 2021. By an interview, we retrospectively investigated first-year post-stroke changes for those ischemic stroke patients that suffered from migraine pre-stroke. Associations between change in migraine frequency/intensity/aura (decrease, no change, increase), stroke location (posterior location vs. other), and use of secondary stroke preventive medication were assessed by ordinal regression with adjustment for confounders.

Results: We included 78 patients (mean age 48 years, 86% women, 47% with aura). Change in migraine symptomatology was reported by 63 (81%) patients; 51 (81%) noticed a decrease in attack frequency (27 no attacks) and 12 (19%) an increase. Pain intensity change was reported by 18 (35%) patients (50% increase, 50% decrease). Aura symptomatology improved in 4 (11%). Reduced attack frequency was not related to posterior stroke (OR = 1.5, 95% CI: 0.6-3.9), or preventive medication (antiplatelets OR = 1.0, 95% CI: 0.2-3.7; coumarin OR = 2.7, 95% CI: 0.4-20.6).

Conclusions: Most patients with active pre-stroke migraine experience improvement of their symptoms in the first year after ischemic stroke. This change does not seem to be related to secondary stroke preventive medication or posterior stroke location.

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缺血性中风后偏头痛症状的变化：一项队列研究。

导言：偏头痛症状被认为在中风后会有所改善。我们旨在确定中风前活动性偏头痛患者中风后的变化，并探讨其与中风位置和中风预防药物使用的关系。方法我们从 2014-2021 年间的三个研究队列中选取了发生缺血性中风的活动性偏头痛患者。通过访谈，我们对中风前患有偏头痛的缺血性中风患者中风后第一年的变化进行了回顾性调查。我们通过序数回归评估了偏头痛频率/强度/先兆变化（减少、无变化、增加）、中风位置（后部位置与其他位置）和中风二级预防药物使用之间的关联，并对混杂因素进行了调整。结果我们纳入了 78 名患者（平均年龄 48 岁，86% 为女性，47% 有先兆）。63名患者（81%）报告了偏头痛症状的变化；51名患者（81%）注意到发作频率下降（27名患者没有发作），12名患者（19%）注意到发作频率上升。18名患者（35%）报告疼痛强度发生了变化（50%增加，50%减少）。4名患者（11%）的先兆症状有所改善。发作频率降低与中风后遗症（OR=1.5，95%CI 0.6-3.9）或预防性药物（抗血小板 OR=1.0，95%CI 0.2-3.7；香豆素 OR=2.7，95%CI 0.4-20.6）无关。结论大多数卒中前活动性偏头痛患者在缺血性卒中后的第一年症状有所改善。这种变化似乎与二级中风预防药物或中风后的位置无关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cerebrovascular Diseases 医学-临床神经学

CiteScore

4.50

自引率

0.00%

发文量

审稿时长

1 months

期刊介绍： A rapidly-growing field, stroke and cerebrovascular research is unique in that it involves a variety of specialties such as neurology, internal medicine, surgery, radiology, epidemiology, cardiology, hematology, psychology and rehabilitation. ''Cerebrovascular Diseases'' is an international forum which meets the growing need for sophisticated, up-to-date scientific information on clinical data, diagnostic testing, and therapeutic issues, dealing with all aspects of stroke and cerebrovascular diseases. It contains original contributions, reviews of selected topics and clinical investigative studies, recent meeting reports and work-in-progress as well as discussions on controversial issues. All aspects related to clinical advances are considered, while purely experimental work appears if directly relevant to clinical issues.