Is there a link between migraines and TIA/stroke in older people?

This study aimed to determine whether there was an association between migraines and cryptogenic transient ischemic attack (TIA) or ischemic stroke. The researchers determined that there is a causal link between migraine and cryogenic TIA or ischemic stroke, particularly in older people.

Ischemic stroke occurs when a blocked blood vessel stops blood reaching the brain. TIA is the temporary stopping of blood flow to the brain which mimics stroke-like symptoms. Cryptogenic TIA or ischemic stroke refers to TIA or stroke where the cause is unknown. Previous studies have found that migraines are associated with a 2-fold increased risk of ischemic stroke. Whether this association is linked with cryptogenic stroke or stroke of a known cause has not been studied.

This study examined the association between migraine and cryptogenic TIA or stroke in older patients. This study included 1810 patients, 1114 with ischemic stroke and 696 with TIA. 36.9% of these were cryptogenic cases. The incidence of migraines was determined based on patient report and medical history.

Cryptogenic TIA or stroke patients had higher incidence of migraine (28%) in comparison to patients with stroke of known causes (18%). Migraines were reported by 27.1% of cryptogenic TIA/stroke patients over 65, compared to 17% of patients in the same age group with stroke of known cause.

The odds of experiencing cryptogenic TIA/stroke were higher for patients with migraines even with no other detected risk factors.

The study found a causal link between migraine and cryptogenic TIA or ischemic stroke in older people with no other vascular risk factors. 

The patients were not screened for patent foramen ovale, which has been shown as a rare cause of stroke and therefore cannot be ruled out fully as a cause of this link between migraine and crytogenic TIA/stroke.