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Migrainous Stroke

Migraine with Ischaemic Complication


Presentation

  • The aim of this study was to recognize patterns of MR perfusion abnormalities in this presentation.[ajnr.org]
  • We compared clinical presentation and metabolite ratios between patient groups. We also studied healthy controls with no history of migraine.[ndcn.ox.ac.uk]
  • The article, Headache In Stroke, A Review, outlines the types of headaches that present in different stroke presentations. In ischemic stroke, headache can be present in a fair number of patients, up to 34% in some studies.[headachejournal.org]
  • It is these patients who are likely to raise suspicion for stroke when they present to the ED.[ahcmedia.com]
  • We present the case of a migrainous patient who had a cerebral infarct during a migrainous crisis. She was 26 weeks pregnant. The infarct, detected on MRI was in the right thalamic region. It presented as left hemiparesia and left hemi-hypo-estesia.[neurologia.com]
Mitral Valve Prolapse
  • The incidences of major stroke risk factors and mitral valve prolapse were no higher for the study group than for the general population of similar age.[ncbi.nlm.nih.gov]
  • We found no significant differences in gender ratio or in the frequency of smoking, estrogen use, hypertension, mitral valve prolapse, or family history of migraine between the two groups.[ncbi.nlm.nih.gov]
  • Increased prevalence of mitral valve prolapse in patients with migraine. Can J Neurol Sci 1984 ; 131 ( 12 ): 1457 – 1460. 113. Gilon, D, Buonanno, FS, Joffe, MM, et al.[cambridge.org]
Muscle Spasm
  • Positive symptoms include visual disturbances such as flashing lights, and motor disturbances such as muscle spasms. Conversely, negative symptoms are caused by a loss of CNS function and manifest as a negation of normal functionality.[saebo.com]
Flushing
  • Symptoms generally last one to 72 hours and include nausea, vomiting, and flushing.[healthline.com]
  • For PWI, 35 dynamic measurements (temporal resolution 2090 ms for each dynamic series) were acquired after bolus injection (flow rate of 5 mL/s), followed by a 20-mL saline flush of a 1.0-mol/L contrast agent, gadobutrol (Gadovist; Bayer HealthCare, Berlin[ajnr.org]
  • However, individuals may respond better to specific ones. [10] Most side effects are mild, such as flushing; however, rare cases of myocardial ischemia have occurred. [5] They are thus not recommended for people with cardiovascular disease, [10] who have[en.wikipedia.org]
Scintillating Scotoma
  • Migraine aura can be what is called scintillating scotoma (the moving, shimmery flickering visual hallucination), or simply a blind spot (scotoma). The migraine scintillating scotoma is often depicted in migraine aura art. Thanks for reading![relieve-migraine-headache.com]
  • The Varying Frequency of Migraines, and Health Risks I have had migraine equivalents (aura without headache) once or twice a year for the last 20 years: I get a scintillating scotoma that fades within half an hour.[consults.blogs.nytimes.com]
  • A fortification spectrum is common or a spreading, scintillating scotoma in the shape of a jagged crescent. Geometric visual patterns and even hallucinations may occur. This is fully reversible. An aura has no motor symptoms.[patient.info]
  • Aura is experienced in 30% of patients up to 60 minutes prior to onset of headache and is commonly described as a shimmering arc of white or colored lights in lateral visual fields (scintillating scotoma) commonly followed by zone of vision loss (negative[clinicaladvisor.com]
Ptosis
  • In ophthalmoplegic migraine, the patient may present with a third nerve palsy, with ocular muscle paralysis, including or sparing the pupillary response, as well as ptosis.[patient.info]
Suggestibility
  • These results suggest that antiphospholipid antibodies associated with migraine may be an important marker for ischemic stroke.[ncbi.nlm.nih.gov]
  • These results suggest that antiphospholipid antibodies associated with migraine may be an important marker for ischemic stroke. 1994 S.[karger.com]
  • But I'll look at the links you've suggested. And I know how frightening TIA's are. I had dozens of them leading up to the main stroke and indeed after it.[healthunlocked.com]
  • […] thrombolytic agents in children Stresses the etiology and pathophysiology of childhood stroke as the basis for evaluation and treatment Maintains the practical, clinical flavor established in previous editions, with numerous illustrations and useful suggestions[books.google.com]
  • Some studies suggest that aura is associated with adverse cardiovascular risk profile and prothrombotic factors.[disabled-world.com]
Stroke
  • Patients with a history of migraine-associated stroke are at significantly increased risk for recurrent stroke.[ncbi.nlm.nih.gov]
  • Twenty-two patients with acute migraine-associated stroke were prospectively evaluated; 91% were female, and 23% had a prior history of presumed migrainous stroke.[ncbi.nlm.nih.gov]
  • Abstract The pathogenesis of migrainous stroke is controversial. The possibility that a number of migraine-related strokes is associated with the presence of antiphospholipid antibodies, a condition predisposing to coagulopathy, has been suggested.[ncbi.nlm.nih.gov]
  • In most, stroke was mild with good recovery and no recurrence. Headache frequency and severity decreased after the stroke.[ncbi.nlm.nih.gov]
  • The possible mechanisms involved in migrainous stroke occurring in association with use of propranolol are discussed.[ncbi.nlm.nih.gov]
Stroke
  • Patients with a history of migraine-associated stroke are at significantly increased risk for recurrent stroke.[ncbi.nlm.nih.gov]
  • Twenty-two patients with acute migraine-associated stroke were prospectively evaluated; 91% were female, and 23% had a prior history of presumed migrainous stroke.[ncbi.nlm.nih.gov]
  • Abstract The pathogenesis of migrainous stroke is controversial. The possibility that a number of migraine-related strokes is associated with the presence of antiphospholipid antibodies, a condition predisposing to coagulopathy, has been suggested.[ncbi.nlm.nih.gov]
  • In most, stroke was mild with good recovery and no recurrence. Headache frequency and severity decreased after the stroke.[ncbi.nlm.nih.gov]
  • The possible mechanisms involved in migrainous stroke occurring in association with use of propranolol are discussed.[ncbi.nlm.nih.gov]
Motor Symptoms
  • Cases with predominantly motor symptoms are also referred to as “hemiplegic migraine.” 25 According to the International Headache Society, 4 these forms are diagnosed clinically by accurate patient history and neurologic examination.[ajnr.org]
  • The migrainous aura consists of transient focal neurological disturbances presenting in the form of visual, sensory or motor symptoms that precede the migraine headache.[brainblogger.com]
  • An aura has no motor symptoms. Those who experience this type of migraine may also have sensory symptoms (paraesthesia or numbness) that are unilateral and also fully reversible.[patient.info]
  • Motor symptoms and aphasia are rare. Migraine headaches are usually, but not always, unilateral, pounding or throbbing (pulsatile) in nature, and associated with photophobia, phonophobia, nausea, and/or vomiting.[clinicaladvisor.com]
  • In addition, somatosensory symptoms are associated with pain and/or paresthesias, and motor symptoms with jerking extremity movements.[ahcmedia.com]
Focal Neurologic Deficit
  • neurological deficit on physical exam.[ahcmedia.com]
  • Careful physical examination is essential for every patient with severe headache, searching for any focal neurological deficit such as mild pronator drift, asymmetry of reflexes and mild hypoesthesia to suspect possible intracranial diseases.[clinicaladvisor.com]
  • None of the patients had a known history of previous attacks of migraine with focal neurologic deficits or other diseases. Nineteen of 20 examinations were performed between 1 and 6 hours after onset (mean interval, 174 minutes).[ajnr.org]
  • This, to us, seems a little suspicious as when we encounter a migraine patient with a focal neurological deficit, we don't call it a "TIA", but we usually call it a "complicated migraine".[dizziness-and-balance.com]
  • Article First Online: 26 April 2007 Abstract Young patients with migraine are at increased risk for stroke, particularly patients with an aura of focal neurologic deficits.[link.springer.com]
Amnesia
  • We report a case of migraine-associated ischemic stroke causing amnesia, wherein treatment with propranolol may have been contributory.[ncbi.nlm.nih.gov]
  • Furthermore, loss of self-activation (apathy) is often present and is commonly accompanied by amnesia, with inability to make new memories, resulting from interruption of the mamillo-thalamic tract.[omicsonline.org]
  • Data was also collected on confusional migraine aura, defined as disorientation and anterograde amnesia, with or without a decreased level of consciousness, [ 19 ] preceding the headache and not requiring hospital admission.[journals.plos.org]

Workup

  • "This does not mean if you have a migraine you should run into the ER for a heart attack workup or a stroke workup," Lyden tells WebMD. It does mean those with migraine should be aware of the potential increased risk, he says.[medicinenet.com]
  • However, in most patients with stroke of unknown origin, a typical diagnostic workup will unveil most of these conditions.[stroke.ahajournals.org]
  • All had undergone a dedicated stroke workup including diffusion-weighted imaging (DWI) and a detailed assessment of clinical features and of vascular risk factors.[neurology.org]
  • You'll have the same diagnostic workup and treatment as anyone of your age with ischemic stroke would.[verywell.com]
  • In the event of a new focal neurological deficit, the initial workup remains unchanged, and if symptoms persist the patient likely warrants admission with neurological consultation.[ahcmedia.com]

Treatment

  • We report a case of migraine-associated ischemic stroke causing amnesia, wherein treatment with propranolol may have been contributory.[ncbi.nlm.nih.gov]
  • The first chapter stresses the etiology and pathophysiology of childhood stroke as the basis for evaluations and treatment.[books.google.com]
  • Additional treatments of acute ischemic strokes vary according to the underlying cause.[cedars-sinai.edu]
  • Access the comprehensive, expert clinical guidance you need to recognize the clinical manifestations of stroke, use the latest laboratory and imaging studies to arrive at a diagnosis, and generate an effective medical and surgical treatment plan.[books.google.com]

Prognosis

  • December 01, 1993 ; 43 (12) Articles Risk factors and prognosis J. Rothrock , J. North , K. Madden , P. Lyden , P. Fleck , H.[neurology.org]
  • The functional prognosis of migrainous stroke is good, with minimal risk of relapse Keywords Migraine Pregnancy Stroke Classified in Cefalea y Migraña - Dolor - Patología vascular You may be interested[neurologia.com]
  • The headaches are usually recurrent, and although RCVS can result in strokes or hemorrhage, most cases have a good prognosis. The classic diagnosis to think of with thunderclap headaches is a subarachnoid hemorrhage.[headachejournal.org]
  • Includes an overview of stroke types, risk factors, prognosis, and diagnostic strategies in neonates, children, and young adults to help you better manage every condition you see.[elsevier.com]
  • First, genetics undoubtedly plays a very prominent role in determining the frequency, severity and long-term prognosis of migraine for an individual sufferer.[consults.blogs.nytimes.com]

Etiology

  • The first chapter stresses the etiology and pathophysiology of childhood stroke as the basis for evaluations and treatment.[books.google.com]
  • “One way to look at etiology is that vertigo is just another part of migraine hypersensitivity, like pain and photophobia. But the short answer is we just don’t know,” said Rosenberg.[neurologyadvisor.com]
  • Likewise, the lack of a corrective saccade raises suspicion for a central vertigo etiology.[ahcmedia.com]
  • Their etiology remains controversial, although changes in cerebral vessel reactivity are involved.[radiopaedia.org]
  • Discusses the diverse etiologies of stroke in children and young adults to increase awareness in the differences of presenting signs between children and adults.[elsevier.com]

Epidemiology

  • Abstract We compared epidemiologic and clinical data from 310 patients with migraine and 30 patients with acute migrainous stroke to identify factors predictive of migrainous stroke and assess the risk of future stroke in these two populations.[ncbi.nlm.nih.gov]
  • Dittrich First published December 1, 1993, DOI: Abstract We compared epidemiologic and clinical data from 310 patients with migraine and 30 patients with acute migrainous stroke to identify factors predictive of migrainous stroke and assess the risk of[neurology.org]
  • Migraine in Women provides discussions on epidemiology, pathogenesis, options for preventative therapy, and headache management strategies.[books.google.ro]
  • Tobias Kurth, adjunct associate professor of epidemiology at the Harvard School of Public Health. "It was followed by diabetes, family history, smoking, and obesity."[health.harvard.edu]
  • One epidemiological study reported an increased risk of hypertension, smoking and hyperlipidemia among migraineurs. A patent foramen ovale was also found to be twice as frequent among young patients with migraine with aura.[headachejournal.org]
Sex distribution
Age distribution

Pathophysiology

  • Gain fresh perspectives and up-to-date insights from the world’s leading authorities on the pathophysiology, diagnosis, and management of stroke.[books.google.com]
  • The first chapter stresses the etiology and pathophysiology of childhood stroke as the basis for evaluations and treatment.[books.google.com]
  • . * A comprehensive source that thoroughly examines the neurological manifestations of stroke * A guide to highly studied topics, including stroke complications, syndromes, and stroke related psychiatric disorders * A better understanding of the pathophysiological[books.google.com]
  • Migrainous infarction is a rare complication of migraine with aura, and its pathophysiology is poorly understood.[ndcn.ox.ac.uk]
  • Migraine: Manifestations, Pathophysiology, and Management, Second Edition, is a much expanded, updated monograph that focuses in detail on migraine's diverse variations, its pathophysiology, and its treatment.[books.google.ro]

Prevention

  • The goals of treatment are to prevent life-threatening complications that may occur soon after stroke symptoms develop, prevent future strokes, reduce disability, prevent long-term complications and help the patient get back as much normal functioning[cedars-sinai.edu]
  • Stay up to date on hot topics such as mechanisms of action of commonly used drugs, neuronal angiogenesis and stem cells, basic mechanisms of spasm and hemorrhage, prevention of stroke, genetics/predisposing risk factors, and much more.[books.google.com]
  • […] manifestations of stroke * A guide to highly studied topics, including stroke complications, syndromes, and stroke related psychiatric disorders * A better understanding of the pathophysiological basis of strokes that will help practitioners better diagnose, prevent[books.google.com]
  • Headache Consortium migraine guidelines, the section on preventive therapy was developed after analysis of data from hundreds of clinical trials on the prevention of migraine.[aafp.org]
  • Prevention It's important to take preventative measures and make any necessary lifestyle changes that can help lower your chance of having migrainous infarction.[verywell.com]

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