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Migraine improvement after spontaneous cervical artery dissection the Italian Project on Stroke in Young Adults (IPSYS). 2019
Valeria De Giuli, and
Francesca Graziano, and
Andrea Zini, and
Marialuisa Zedde, and
Rosalba Patella, and
Corrado Lodigiani, and
Simona Marcheselli, and
Maria Luisa DeLodovici, and
Maurizio Paciaroni, and
Ilaria Casetta, and
Elisa Giorli, and
Alessandro Adami, and
Massimiliano Braga, and
Carmela Casella, and
Alessia Giossi, and
Giorgio Silvestrelli, and
Lucia Tancredi, and
Enrico Maria Lotti, and
Loris Poli, and
Filomena Caria, and
Valeria Piras, and
Laura Cucurachi, and
Massimo Gamba, and
Mario Grassi, and
Alessandro Padovani, and
Alessandro Pezzini, and
Dipartimento di Scienze Cliniche e Sperimentali, Clinica Neurologica, Università degli Studi di Brescia, P.le Spedali Civili, 1,, 25123, Brescia, Italy.
OBJECTIVE Whether migraine modifies after spontaneous cervical artery dissection (sCeAD) more than after other stroke etiologic subtypes has never been adequately investigated. METHODS In the setting of the Italian Project on Stroke in Young Adults (IPSYS), we compared the course of migraine before and after acute brain infarct in a group of migraine patients with sCeAD and a group of migraine patients whose ischemia was due to a cause other than CeAD (non-CeAD IS), matched by sex, age (± 3 years), and migraine subtype.We applied linear mixed models to evaluate pre-event vs post-event changes and differences between sCeAD and non-CeAD IS patients. RESULTS Eighty-seven patients per group (migraine without aura/migraine with aura, 67/20) qualified for the analysis. After the acute event, migraine headaches disappeared in 14.0% of CeAD patients vs 0.0% of non-CeAD IS patients (p ≤ 0.001). Migraine frequency (patients suffering at least 1 attack, from 93.1 to 80.5%, p = 0.001), pain intensity (from 6.7 ± 1.7 to 4.6 ± 2.6 in a 0 to 10 pain scale, p ≤ 0.001), and use of acute anti-migraine medications (patients taking at least 1 preparation, from 81.6 to 64.4%, p = 0.007) also improved significantly after CeAD as opposed to that observed after non-CeAD IS. CONCLUSIONS The spontaneous improvement of migraine after sCeAD reinforces the hypothesis of a pathogenic link between the two conditions.
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