Migraine with aura is a risk factor for ischaemic stroke, or heart disease.[Dodick, 2009] Although as yet unclear, the mechanisms behind this increased risk are thought to centre around an underlying pathology in the vasculature, driven by genetic differences, vasculopathies, and endothelial dysfunctions (impaired functioning of the lining of blood vessels).[Dodick, 2009] The interaction of migraine and ischaemic stroke risk make the management of some patients (particularly females) more complicated; the use of oestrogen versus progestin contraceptives, and the use of acetylsalicylic acid, should be finely balanced treatment decisions.[Dodick, 2009; Bashir et al., 2013] Whatever the cause of the increased stroke risk in people with migraine, at-risk individuals should be evaluated for other stroke risk factors as part of an integrated treatment approach.[Bashir et al., 2013]
Other reference used on slide:
Buse DC, Manack A, Serrano D, et al. Sociodemographic and comorbidity profiles of chronic migraine and episodic migraine sufferers. J Neurol Neurosurg Psychiatry 2010; 81 (4): 428–432.