Migraine and Risk of Stroke in Young Women

Purpose: To explore the relationship between migraine and incidence of stroke in young women by analyzing variables of oral contraceptive use, hypercoagulability, cardiac abnormalities, and silent brain infarcts. Method: Variables were reviewed through computerized databases and current literature examining evidence-based medicine studies specific to analyzing the incidence of strokes in women with migraines. Results: Six recent studies, four case control and two cohort studies, were identified. Research outcomes indicate that the risk of stroke is greater in women less than 35 years of age who had migraine with aura and who used oral contraceptives. Other pathophysiologic variables, which may link migraine to stroke, include hypercoagulability, cardiac abnormalities, and silent brain infarcts. Conclusion: Young women with migraine appear to be at higher risk of ischemic stroke than women without migraine. This risk is further increased by the co-existence of other established risks including hypertension, smoking, and oral contraceptives. Patent foramen ovale, silent brain infarcts, and hypercoagulability are underlying mechanisms that appear to link migraine to stroke. Clinical studies and research into the pathophysiology of migraine is essential to explain why migraine patients are at higher risk of ischemic stroke.