risk of stroke

Many studies have found an association between migraine history and risk of stroke. A new study published in The BMJ assessed whether post-operative patients with migraines were at an increased risk for stroke, and found that migraines doubled the relative risk of ischemic stroke in these patients.

 

Migraine is a headache disorder consisting of severe pulsating headaches that last anywhere from 2 to 72 hours. These headaches are often accompanied by nausea, vomiting, and sensory hypersensitivities including sensitivity to light and sound. 15-20% of the general population experience migraines and up to two-thirds of cases of migraines runs in the family. However, environmental contributions to migraine risk are at play as well.

Many studies have shown an association between migraine history and increased risk of ischemic stroke. Ischemic stroke occurs when there is a lack of blood flow to the brain, which results in brain cell death, causing some regions of the brain to be temporarily or permanently damaged.  Strokes are responsible for 6.2 million deaths per year. Interestingly, approximately 1 in 1000 individuals experience a stroke following a medical surgery. Given that over 50 million individuals undergo surgical procedures in the United States every year, this is a very concerning complication.

The association between migraines and ischemic stroke has not previously been studied in the perioperative setting. A new study published in The BMJ evaluated whether patients with migraines were at an increased risk of ischemic stroke following a medical surgery. They assessed 124,558 surgical patients on migraine diagnosis, perioperative ischemic stroke, and hospital readmission within 30 days of surgery.

Surprisingly, patients with migraines showed an increased risk for ischemic stroke following surgery when compared to patients without migraines. The authors predict that 2.4 ischemic strokes will be seen for every 1000 patients, and this risk increases to 4.3 for every 1000 patients who have migraines, meaning that migraines double the relative risk of stroke. Additionally, patients with migraines were more likely to be readmitted to the hospital within 30 days after surgery.

The results of this study add to the growing collection of evidence that migraine is a risk factor for ischemic stroke, and should be considered a marker for the disease. Migraines are currently viewed as a harmless though inconvenient condition. However, physicians should be advised to monitor patients with migraine more closely for ischemic stroke, especially following surgery.

 

Written By: Neeti Vashi, BSc

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