![]() Indeed, recent imaging studies document an accelerated infarct progression with only little potentially salvageable brain tissue in acute stroke patients with a migraine history, suggesting an increased vulnerability towards cerebral ischemia. At the same time, studies suggest an increased incidence of coagulopathy, atrial fibrillation and patent foramen ovale among migraineurs, providing a possible path for microembolic induction of SD and, in rare instances, stroke in hyperexcitable brains. Migraine patients are at risk for particularly cardioembolic stroke. Recent epidemiologic and imaging studies suggest that these preclinical findings can be extrapolated to migraine patients. Pharmacological suppression of the genetically enhanced SD susceptibility normalizes the stroke phenotype in familial hemiplegic migraine mutant mice. The severe stroke phenotype can be explained by SD-related downstream events that exacerbate the metabolic mismatch, including pericyte contraction and neuroglial inflammation. Migraine mutant mice also exhibit an increased frequency of ischemia-triggered SDs upon experimental stroke, associated with accelerated infarct growth and worse outcomes. Upon experimentally induced SD, these mice develop aura-like neurological symptoms, akin to patients with the respective mutations. Increased SD susceptibility has been demonstrated in migraine animal models, including transgenic mice carrying human mutations for the migraine-associated syndrome CADASIL and familial hemiplegic migraine (type 1 and 2). Spreading depolarization (SD), a slowly propagating wave of neuronal depolarization, is the electrophysiologic event underlying migraine aura and a known headache trigger. Preclinical models have provided us with possible mechanisms to explain the increased vulnerability of migraineurs’ brains towards ischemia and suggest a key role for enhanced cerebral excitability and increased incidence of microembolic events. Interestingly, stroke risk is highest for migraineurs who are young and otherwise healthy. Migraine, especially with aura, is a risk factor for both ischemic and hemorrhagic stroke. doi:10.Population-based studies have highlighted a close relationship between migraine and stroke. The typical duration of migraine aura: a systematic review. Viana M, Sprenger T, Andelova M, Goadsby PJ. ![]() Life with migraine: effects on relationships, career, and finances from the chronic migraine epidemiology and outcomes (CaMEO) study. Migraine triggers.īuse DC, Fanning KM, Reed ML, et al. ![]() Proceedings of the 2018 Designing Interactive Systems Conference. Examining self-tracking by people with migraine: goals, needs, and opportunities in a chronic healthcondition. Schroeder J, Chung C-F, Epstein DA, et al. The timeline of a migraine attack.Īmerican Migraine Foundation. Clinical features of visual migraine aura: a systematic review. Differences in treatment response between migraine with aura and migraine without aura: lessons from clinical practice and RCTs. Association of migraine with aura and other risk factors with incident cardiovascular disease in women. Kurth T, Rist PM, Ridker PM, Kotler G, Bubes V, Buring JE.
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