Frequency and clinical implications of hypercoagulability states in a cohort of patients with migraine with aura

Excerpt

Migraine is the most common neurological disorder, affecting 12% of the adult population. Migraine with aura (MA) accounts for 15% of all migraines and its typical symptoms include temporary visual or sensory of aphasic disturbances that usually strike before clinical migraine symptoms. Migraine auras can be confused with transient ischemic attack (TIA), where there are stroke symptoms passing in a short time. However, patients affected by MA present a higher cerebrovascular risk with respect to general population, in particular for cardioembolic or criptogenetic stroke. This was pointed out by a study [1] with 1.622 migraineurs compared to nonheadache participants: there was a significant association between migraine with visual aura and ischemic stroke (hazard ratio 1.7, 95% confidence interval 1.2–2.6, p = 0.008). This incidence of stroke in patients with MA may be only in part linked to the higher prevalence of patent foramen ovale (PFO) in these patients [2]. Few studies reported controversial findings about the association of MA with hypercoagulability states (HS), but a study [3] on 154 patients with stroke, of whom 59 with a history of migraine, showed that HS were more frequent in the migraine than in the non-migraine group (38.6 vs. 16.4%, p < 0.01). …