Abstract：
BACKGROUND: Migraine symptoms are postulated to improve post-stroke. We aimed to determine post-stroke changes in patients with active migraine pre-stroke and explored the relation with stroke location and stroke-preventive medication use.
METHODS: Patients with active migraine who had an ischemic stroke were retrieved from three research-cohorts between 2014 and 2021. By an interview, we retrospectively investigated first-year post-stroke changes for those ischemic stroke patients that suffered from migraine pre-stroke. Associations between change in migraine frequency/intensity/aura (decrease, no change, increase), stroke location (posterior location vs. other), and use of secondary stroke preventive medication were assessed by ordinal regression with adjustment for confounders.
RESULTS: We included 78 patients (mean age 48 years, 86% women, 47% with aura). Change in migraine symptomatology was reported by 63 (81%) patients; 51 (81%) noticed a decrease in attack frequency (27 no attacks) and 12 (19%) an increase. Pain intensity change was reported by 18 (35%) patients (50% increase, 50% decrease). Aura symptomatology improved in 4 (11%). Reduced attack frequency was not related to posterior stroke (OR = 1.5, 95% CI: 0.6-3.9), or preventive medication (antiplatelets OR = 1.0, 95% CI: 0.2-3.7; coumarin OR = 2.7, 95% CI: 0.4-20.6).
CONCLUSIONS: Most patients with active pre-stroke migraine experience improvement of their symptoms in the first year after ischemic stroke. This change does not seem to be related to secondary stroke preventive medication or posterior stroke location.
METHODS: Patients with active migraine who had an ischemic stroke were retrieved from three research-cohorts between 2014 and 2021. By an interview, we retrospectively investigated first-year post-stroke changes for those ischemic stroke patients that suffered from migraine pre-stroke. Associations between change in migraine frequency/intensity/aura (decrease, no change, increase), stroke location (posterior location vs. other), and use of secondary stroke preventive medication were assessed by ordinal regression with adjustment for confounders.
RESULTS: We included 78 patients (mean age 48 years, 86% women, 47% with aura). Change in migraine symptomatology was reported by 63 (81%) patients; 51 (81%) noticed a decrease in attack frequency (27 no attacks) and 12 (19%) an increase. Pain intensity change was reported by 18 (35%) patients (50% increase, 50% decrease). Aura symptomatology improved in 4 (11%). Reduced attack frequency was not related to posterior stroke (OR = 1.5, 95% CI: 0.6-3.9), or preventive medication (antiplatelets OR = 1.0, 95% CI: 0.2-3.7; coumarin OR = 2.7, 95% CI: 0.4-20.6).
CONCLUSIONS: Most patients with active pre-stroke migraine experience improvement of their symptoms in the first year after ischemic stroke. This change does not seem to be related to secondary stroke preventive medication or posterior stroke location.
摘要：
引言假定偏头痛症状可以改善中风后。我们旨在确定中风前活动性偏头痛患者的中风后变化，探讨卒中部位与卒中预防用药的关系。方法从2014-2021年的三个研究队列中检索出患有缺血性卒中的活动性偏头痛患者。通过访谈，我们回顾性调查了中风前偏头痛的缺血性中风患者中风后第一年的变化。偏头痛频率/强度/先兆变化之间的关联（减少，没有变化,增加)，中风位置(后部位置与其他位置相比)，我们通过校正混杂因素的序数回归对继发性卒中预防药物的使用进行评估.结果我们纳入了78例患者(平均年龄48岁，86%的女性47%带有光环）。63例（81%）患者报告了偏头痛症状的变化；51例（81%）患者注意到发作频率降低（27例没有发作）。和12（19％）增加。18例（35%）患者报告疼痛强度变化（增加50%，减少50%)。先气症状改善4例（11％）。发作频率降低与后中风无关（OR=1.5，95CI0.6-3.9），或预防性药物（抗血小板OR=1.0，95CI0.2-3.7；香豆素OR=2.7，95CI0.4-20.6）。结论大多数活动性卒中前偏头痛患者在缺血性卒中后1年内症状改善。这种变化似乎与继发性中风预防药物或后部中风位置无关。
