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Query: UMLS:C0038454 (stroke)
 147,016 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A woman having common migraine attacks coincident with an asymmetrical bilateral occipital lobe infarction that spared the brainstem and cerebellum underwent these studies: serial electroencephalography, brainstem auditory, visual and somatosensory evoked potentials, magnetic resonance imaging of the brain and cerebral arteriography. The patient's vision improved greatly during a one-year follow-up. The absence of risk factors for stroke suggested that migraine caused the infarction in the posterior circulation network. The pathophysiological mechanisms of stroke in migraine remains speculative.
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PMID:Bilateral occipital lobe infarction in acute migraine: clinical, neurophysiological, and neuroradiological study. 152 69

I studied 9 patients with migraine and posterior circulation ischemia. Inclusion criteria were (1) brainstem or cerebellar infarcts or transient ischemic attacks, (2) satisfactory vertebrobasilar angiograms, and (3) migraine. Excluded were patients with only occipital lobe ischemia, known arteriosclerosis, or other nonmigrainous vascular disease. Two women and 7 men, ages 6 to 58 years (mean, 34.7), had transient attacks only (2), single strokes (4), single stroke followed by attacks (1), or multiple strokes (2). Five had antecedent classic, 2 common migraine, and classic migraine began only after the initial ischemic event in the other two. The 7 stroke patients all had CT- or MRI-documented brainstem (4) or cerebellar (6) infarcts. Angiography was normal (3) or demonstrated basilar artery (BA) narrowing (2) or occlusion (4), or branch occlusion (1). In 3 patients the initially occluded BA later reopened. At follow-up (average 4.3 years, range 1 to 9 years), 5 were normal and 4 had important clinical deficits. I conclude that (1) "basilar migraine" is not always benign; it affects both sexes and a wide age range; (2) the pattern of headaches, attacks, and strokes varies; (3) migraine may appear only after ischemia; (4) some patients have BA occlusion or diffuse narrowing; and (5) BA occlusion can be temporary.
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PMID:Migraine and vertebrobasilar ischemia. 192 34

A 30-year-old woman with a history of common migraine developed a permanent left homonymous hemianopia during a typical headache. CT scan demonstrated a right posterior cerebral infarction and angiography showed irregular narrowing of the ipsilateral posterior cerebral artery, suggestive of vasospasm. In the case no risk factors for atherosclerotic stroke were present except for smoking, and no other causes of stroke could be found.
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PMID:Angiographic changes suggestive of vasospasm in migraine complicated by stroke. 207 66

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.
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PMID:Transient ischaemic attacks in young patients: a thromboembolic or migrainous manifestation? A 10 year follow up study of 46 patients. 229 92

Sixty-one consecutive patients, less than or equal to 40 years old, were hospitalized for cerebral infarction between 1977 and 1985. Evaluation included computed tomographic brain scan, arteriography, echocardiography, and blood tests. A probable migrainous infarction was diagnosed in six patients (10%) (all women with a history of migraine) who survived the initial stroke and were followed-up for an average of four years. In five patients the stroke occurred during a common migraine attack and in one patient during a classic migraine attack. The site of infarction was invariably the occipital lobe. During the follow-up, no subject had a further stroke. All six women had a permanent hemianopic deficit.
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PMID:Ischemic stroke in young adults: the relevance of migrainous infarction. 261 82

Stroke is a well described complication of migraine. Recently, attention has been drawn to the development of cerebral hemorrhage in middle-aged patients with common migraine. We report a patient with classic migraine who developed an intracranial hemorrhage 36 h after the onset of a migraine attack and had a good recovery over a period of six days. Including our patient there are now five cases, all females, with this complication of migraine. It is postulated that the condition is fairly common and under reported.
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PMID:Migraine and intracerebral hemorrhage. 270 75

To help resolve the uncertain relationship between migraine headache and ischemic stoke, we performed a hospital-based, case-control study. Eighty-nine cases ages 15-65 with a head computed tomography (CT) scan supported diagnosis of ischemic stroke were matched to 178 control subjects. Using information obtained by telephone interview, the patients were placed into three categories according to explicit criteria: classic migraine; common migraine; and no migraine headache. Overall, the association between migraine and ischemic stroke is significantly increased only in patients with classic migraine [odds ratio (OR) = 2.6, 95% confidence interval (CI) 1.1-6.6]. In addition, classic migraine does not appear to increase ischemic stroke when hypertension, diabetes or smoking are present; however, when these other risk factors are absent, classic migraine is strongly and significantly associated with the risk of ischemic stroke [no hypertension, OR = 5.7 (95% CI 1.6-20.2); no diabetes, OR = 3.4 (95% CI 1.2-9.3); non-smoker OR = 4.3 (95% CI 1.2-15.0)]. Since none of the migraine patients in our study had a migrainous stroke, an underlying disorder other than prolonged vasospasm may be responsible for the observed increased risk. Our data suggest that classic migraine may be a marker for patients at increased risk for ischemic stroke unrelated to a migraine attack.
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PMID:A controlled study of ischemic stroke risk in migraine patients. 276 Jun 69

Clinical and radiologic findings in 13 patients (11 women, 2 men) with extracranial vertebral artery dissection are reported. Dissection was spontaneous in 8 patients, occurred after neck manipulation in 2 and after a potential minor injury to the neck in 3. Six had a history of common migraine, 4 were using oral contraceptives at the time of dissection, and 3 had fibromuscular dysplasia. Dissection was bilateral in 8 patients and associated with carotid dissection in 3. It usually presented with neck or occipital pain preceding basilar ischemic symptoms by a few minutes to 1 month. In 3 patients, transient ischemic attacks were the only manifestation of basilar ischemia, and in 1 patient there was no symptom of basilar ischemia despite bilateral vertebral dissection. In 19 of the 21 dissected vertebral arteries, the angiographic appearance was that of an irregular stenosis, which was associated in 6 arteries with pseudoaneurysmal formation. In 2 patients, 1 vertebral artery was occluded but the contralateral artery showed the typical irregular stenosis. The dissection involved only the third segment in 33%, only the second segment in 24%, and 2 or more segments in 38%. Eleven patients were treated with anticoagulants and 2 with aspirin; 11 recovered without sequelae and 2 had residual deficit. No recurrence was observed (mean follow-up 34 months). At control angiography (n = 12) or ultrasonic study (n = 1), 63% of dissected vertebral arteries had returned to normal, 26% showed marked improvement, and 11% were occluded. Our patient characteristics are compared with those of previously published cases. The validity of the distinction between spontaneous dissection and dissection associated with minor trauma is discussed.
Stroke
PMID:Extracranial vertebral artery dissections: a review of 13 cases. 331 2

Sudden, transient loss of vision in one eye (amaurosis fugax) is associated frequently with atherosclerosis of the internal carotid artery in adults and may herald a stroke. Thus, cerebral angiography is often performed. Amaurosis fugax in children is uncommon and an underlying cause is rarely demonstrated. Recurrent episodes of amaurosis fugax occurred in five adolescents. A characteristic evolution and pattern of visual loss, consistent with choroidal ischemia as the underlying mechanism, was described by four of them. Although none of the episodes were accompanied by headache, four patients had a history of common migraine at other times or a family history of migraine. These episodes of visual loss may represent a migraine variant, and cerebral angiography is not indicated in adolescents with such a history.
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PMID:Amaurosis fugax in teenagers. A migraine variant. 334 21

Regional cerebral blood flow (rCBF) was measured as gray matter blood flow using the 133Xe inhalation technique in 50 pain-free headache patients: Eight patients having classic migraine with normal computed tomograms were matched to patients having common migraine and to normal controls. Interictal rCBF was determined at least 6 days after the last migraine attack and more than 24 hours before the next one. There were no between-group differences for age, PCO2, mean hemispheric blood flow, interindividual and intraindividual variabilities, hyperfrontality, or rCBF symmetry. However, when subjects were classified as to overall abnormal perfusion, a significant number (n = 4, p less than 0.04) of patients with classic migraine had rCBF abnormalities, whereas only one such patient was seen in the group with common migraine. Patients with classic migraine had abnormal mean hemispheric blood flows or disturbed intrahemispheric rCBF patterns. Oligemic and hyperemic regions topographically corresponded to the clinical symptoms in one patient. We conclude that during migraine attacks and interictally there is an instability of rCBF control in patients with classic but not common migraine.
Stroke 1988 Sep
PMID:Abnormalities of interictal cerebral perfusion in classic but not common migraine. 341 8


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