Migraine with Visual aura and the Risk of Stroke- a Narrative Review

 Wasn't this already proven in September 2017? 

Migraine with aura – but not without – increases risk of stroke  Sept. 2017

And your doctor has you on a migraine prevention protocol? Is sex your doctor's answer?

I think by age 31 my migranes stopped  when I quit being a manager. Never did have them with aura.  If this is you you will need to demand dementia prevention protocols from your doctor. Does your doctor know about the sex link below?

From another piece of research, you might want to have sex.

34% of the patients had experience with sexual activity during an attack; out of these patients, 60% reported an improvement of their migraine attack (70% of them reported moderate to complete relief) and 33% reported worsening.

Dementia Linked to Previous Migraine History

Midlife migraine diagnosis boosted dementia rate by 50%, Danish study shows

Migraine with Visual aura and the Risk of Stroke- a Narrative Review

• Meng-Chun Chiang, MD
• Oana M. Dumitrascu, MD, M.Sc.
• Nikita Chhabra, DO
• Chia-Chun Chiang, MD

Published:August 27, 2021DOI:https://doi.org/10.1016/j.jstrokecerebrovasdis.2021.106067

Abstract

Objectives

Patients with migraine with visual aura (MwvA) often present to eye care providers for evaluation. A thorough ophthalmological history and examination is needed to exclude ophthalmologic disorders. Additionally, it has been increasingly recognized that MwvA is associated with ischemic stroke (IS). The aim of this narrative review is to provide a comprehensive overview of the differential diagnosis of MwvA and its association with IS.

Materials and methods

We conducted a PubMed search using key words including “migraine aura”, “visual aura without headache”, “late onset migraine accompaniment”, “migraine and stroke”, “migraine and atrial fibrillation”, and “migraine and patent foramen ovale (PFO)”. We narratively summarized the main findings of the identified studies in sections including age of onset and frequency of migraine with aura, stroke subtypes, and the role of cardioembolism in the migraine-stroke association.

Results and Conclusion

For women younger than 50 years, MwvA is associated with an increased risk of IS, and the risk further increases in patients who also smoke and use oral contraceptives. Age of onset of MwvA 50 years or greater is associated with IS that occurs in late life. Studies reported that increased frequency of aura is associated with an increased risk of IS in women. MwvA is associated with an increased risk of cardioembolic stroke and a higher incidence of atrial fibrillation compared to migraine without aura. Most studies that assessed the migraine-stroke association were based on patients with MwvA. The risks of stroke associated with other types of migraine aura or aura without headache, as well as such association in men require further investigation. More data is needed to determine the absolute risk of stroke when evaluating MwvA in situations including smoking and low dose estrogen use, new or late onset (>50 years) MwvA, to facilitate the development of practice guidelines for stroke prevention in specific clinical scenarios.

Key Words

• Migraine aura
• Visual aura
• Ischemic stroke
• Atrial fibrillation
• Patent foramen ovale

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