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Migraine Associated with Stroke Related to Surgery

Migraine has already been identified as a risk factor for ischemic stroke. A recent study looks more at this connection, suggesting surgery patients with migraine are at an increased risk of stroke around the time of a surgical procedure.

Of the 124,558 surgical patients studied, 771 had a stroke within 30 days of surgery. Strokes were more likely to occur after vascular, cardiac, or neurosurgical procedures, surgeries that are considered high-risk for complications, according to the researchers.

Compared to those without migraine, the study found that patients with migraine had an increased risk for perioperative (time period spanning the duration of a patient’s surgery, including preoperative and postoperative) ischemic stroke and the risk was even higher for those with migraine with aura. This connection was present after adjustments for age, sex, and pre-existing vascular disease.

“Migraine should be incorporated in the assessment for risk of perioperative stroke,” Matthias Eikermann, MD, PhD, one author of the study, told Medscape Medical News.

The study looked at patients at Massachusetts General Hospital and two affiliated hospitals from January 2007 to August 2014. Of the patients who had surgery, 8.2% of patient had been diagnosed with migraine. Those with migraine were also more likely to be readmitted to the hospital within 30 days of discharge after surgery.

“In this large cohort of surgical patients, migraine was associated with an increased risk of perioperative ischemic stroke within 30 days of surgery,” the authors of the study concluded. The study was published online in the British Medical Journal.

The authors said this study adds to evidence that migraine, specifically migraine with aura, is a marker for increased risk of stroke.

“We contend that this association has clinical relevance in a growing list of risk factors that should be considered to promote disability-free survival,” the authors of the study said.

The authors noted that though people with migraine have increased increased, the absolute risk is low. Hypertension, smoking, and other standard risk factors should be the focus for reducing the risk of cardiovascular disease, whether one has migraine or not.

*This article has been updated to better reflect the results of the study. The National Headache Foundation apologizes for the error.

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