The Association of Migraine with Ischemic Stroke

Migraine is a common, chronic-intermittent primary headache disorder affecting mostly women. The migraine pathophysiology involves both the neuronal and vascular systems, and in some patients, transient neurologic symptoms occur, which are known as migraine aura. A large body of literature supports an association between migraine and ischemic stroke, which is apparent mostly in young women with migraine with aura. Further increased risks have been observed particularly in smokers and women who use oral contraceptives. The vast majority of individual studies, as well as a recent meta-analysis, did not find an association between migraine without aura and ischemic stroke. Although there are several hypotheses about potential biological mechanisms linking migraine with aura to ischemic stroke, the precise causes remain unclear. Because the absolute risk of stroke is considerably low in patients with migraine, the vast majority of migraine patients will not experience a stroke event because of the migraine.