Migraine and stroke risk

Evaluation of: Scher AI, Gudmundsson LS, Sigurdsson S et al.: Migraine headache in middle age and late-life brain infarcts. JAMA 301, 2563–2570 (2009). Migraineurs are at increased risk for clinical cardiovascular events, although these events do not commonly occur. The long-term burden of migraine on brain health was considered to be more substantial than previously thought when data from the Dutch Cerebral Abnormalities in Migraine, an Epidemiological Risk Analysis study reported markedly increased risk of subclinical infarcts, primarily in the cerebellum, in migraineurs. The larger, Age Gene/Environment Susceptibility-Reykjavik study recently provided data that confirmed an increased risk of subclinical, cerebellar infarcts in women with migraine with aura, especially those experiencing visual aura. While these data were not linked with clinical examinations of subtle neurological loss over time, they raise important questions regarding the need to screen for and correct modifiable risk factors for cardiovascular disease in migraineurs.