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Migraine and stroke are two common and heterogeneous neurovascular disorders responsible for a significant burden for those affected and a great economic cost for the society. There is growing evidence that migraine increases the overall risk of cerebrovascular diseases. In this review, based on available literature through a PubMed search, we found that ischaemic stroke in people with migraine is strongly associated with migraine with aura, young age, female sex, use of oral contraceptives and smoking habits. The risk of transient ischaemic attack also seems to be increased in people with migraine, although this issue has not been extensively investigated. Although migraine appears to be associated with haemorrhagic stroke, the migraine aura status has a small influence on this relationship. Neuroimaging studies have revealed a higher prevalence of asymptomatic structural brain lesions in people with migraine. They are also more likely to have unfavourable vascular risk factors; however, the increased risk of stroke seems to be more apparent among people with migraine without traditional risk factors. The mechanism behind the migraine-stroke association is unknown. In light of the higher risk of stroke in people with migraine with aura, it is important to identify and modify any vascular risk factor. There is currently no direct evidence to support that a migraine prophylactic treatment can reduce future stroke in people with migraine. [ABSTRACT FROM AUTHOR]

A comparison of the elementary visual hallucinations of 50 patients with migraine and 20 patients with occipital epileptic seizures showed that epileptic seizures are predominantly multi-coloured with circular or spherical patterns as opposed to the predominantly black and white linear patterns of migraine. This simple clinical symptom of the elementary visual hallucinations may be helpful in distinguishing between classic or basilar migraine and visual partial epileptic seizures, particularly in children. Claims that epileptic seizures are triggered or caused by migraine may be artificial, reflecting problems in the differential diagnosis between the two diseases. [ABSTRACT FROM AUTHOR]

Patients with "migraine aura without headache" can be separated from those with transient ischaemic attacks (TIA) on the basis of the onset of symptoms, which is generally gradual and which spread or intensify over minutes or hours, and from the typical migrainous nature of their visual symptoms. Fifty cases were prospectively identified and these were compared with 50 age matched patients with a TIA. Surprisingly, there were no significant differences in the prevalence of vascular risk factors and diseases in the two groups although those with TIAs tended to have more. Only one patient with "migraine aura without headache" suffered a subsequent vascular event (a myocardial infarction). Three patients with TIAs had strokes and two others died from vascular disease. Although the results are not conclusive, they do suggest that patients with the clinical characteristics of "migraine aura without headache" have a low risk of subsequent vascular events, lower than those with TIAs, despite perhaps having similar prevalence of vascular risk factors. Although their risk factors should be treated, patients with "migraine aura without headache" should be reassured and not subjected to inappropriate and potentially hazardous investigations and treatment. [ABSTRACT FROM AUTHOR]

Forty six patients aged 18-39 years with transient ischaemic attacks (TIA) were studied; two thirds were women. Twenty five patients had attacks accompanied by headache, and seven gave a history of common migraine. Only four of 27 angiograms were abnormal; no operable carotid lesion was demonstrated. Over a mean follow up period of 10 years stroke or myocardial infarction (AMI) occurred in all four patients who presented major cerebrovascular risk factors, but in only two of the remaining 42 patients. Thus irrespective of age thromboembolic TIA is a harbinger of stroke or AMI. However, most TIAs under the age of 40 years are caused by a non-embolic benign vascular disorder. The clinical characteristics, long-term prognosis, and possible pathogenesis, for such attacks are often indistinguishable from those of classical migraine. In the absence of cardiovascular risk factors, arteriography does not provide much diagnostic and prognostic information. [ABSTRACT FROM AUTHOR]

The clinical and visual evoked potential (VEP) findings were analysed in 18 patients with anterior ischaemic optic neuropathy. The VEP studies showed a variety of abnormalities which could be interpreted as being the result of subcomponent interaction consequent upon loss or attenuation of the normal macular-derived P100 component. Delay of normal VEP subcomponents was not seen. The VEP findings were non-specific but pointed to a severe disturbance of transmission in optic nerve fibres subserving central vision. No significant changes were observed with time in most cases indicating a static monophasic process with no significant recovery. [ABSTRACT FROM AUTHOR]

Presents a letter to the editor about the red ear syndromes.