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Articles
Vision Loss During Migraines Linked to Strokes
NEW ORLEANS, Feb. 3 - Two studies presented at the American Stroke Association's International Stroke Conference seemed to confirm a strong link between migraine headaches and strokes.
In the first study, Italian researchers investigated whether migraine (with or without aura) could be a risk factor for strokes in patients ages 16 to 44. Examining data from 238 male and female stroke patients, and an equal number of control subjects, they found that 63 stroke survivors had experienced migraines compared with only 33 people in a control group. Researchers were able to rule out smoking, alcohol intake, and contraceptive pill use, as factors that might explain the difference. When migraine was combined with high blood pressure, the stroke risk increased even more, said Massimo Camerlingo, M.D., head of the neurologic unit at Policlinico San Marco in Osio Sotto (Bergamo), Italy.
The second study addressed the question of whether there is a link between strokes and migraine-related vision loss. Migraines are often preceded by aura, sometimes of an auditory nature but more often as visual phenomena including visioni loss. Migraines with visual aura have been associated with ischemic stroke, but researchers at the Centers for Disease Control in Atlanta wantedto know if strokes could be linked with any particular type of visual disturbance. Their study whoed that women who experience vision loss as a symptom of migraine have a 70 percent increase for the risk of stroke compared to women who don't have migraines.
"Our study found that women who suffer migraines with loss of vision or partial loss of vision were 1.7 times more likely to have stroke compared with women who do not have a history of migraines," said study author Wayne H. Giles, M.D., M.S., associate director for science in the Division of Adult and Community Health at the CDC. The study included 963 women between ages 15 and 49; 542 of them had suffered strokes.
Women who see spots and lines during or just before migraine had a 25 percent increased risk of stroke over women without migraines. But women who experience vision loss during or before migraine had a 70 percent higher risk. This may indicate that vision loss is more likely to represent transient cerebral ischemia than seeing spots and lines.
The prevalence of migraine - in general - is about 17 percent in women, and the prevalence of migraine with aura, is about 5 percent in women, Giles said. Of those with aura, more than 90 percent of patients report visual symptoms, such as light sensitivity; seeing lines or spots; seeing flashes of light or temporary loss of vision, he said.
"Other case-control studies had shown that migraine with aura was more strongly associated with stroke, but ours is the first to examine the type of aura symptom and the likelihood of stroke," Giles said.
These findings need independent confirmation from other investigators, but they indicate that women with migraine and aura should address all other stroke risk factors, particularly smoking. Women with migraine and aura should also be aware that oral contraceptives may increase their risk of stroke, and they should discuss the risk/benefit ratio of these agents with their doctors, Giles said.
Giles emphasized that migraine sufferers who experience new neurological symptoms, including transient loss of vision, should be evaluated by a doctor to exclude other causes such as transient ischemic attack (TIA). A TIA, which is caused by reduced blood flow in the brain, can result in a temporary loss of vision and can occur independent of migraine, he said.
[SOURCE: American Heart Association.] |
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