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REVIEW article

Front. Neurol.
Sec. Stroke
Volume 15 - 2024 | doi: 10.3389/fneur.2024.1435208

Reviewing Migraine-Associated Pathophysiology and Its Impact on Elevated Stroke Risk

Provisionally accepted
Vikas Ravi Vikas Ravi 1Sima Osouli Meinagh Sima Osouli Meinagh 2Reza Bavarsad Shahripour Reza Bavarsad Shahripour 3*
  • 1 neurology, Loma Linda University Health Care, Loma Linda, California, United States
  • 2 neurology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  • 3 neuroscience, University of California, San Diego, La Jolla, California, United States

The final, formatted version of the article will be published soon.

    Migraine affects up to 20 percent of the global population and ranks as the second leading cause of disability worldwide. In parallel, ischemic stroke stands as the second leading cause of mortality and the third leading cause of disability worldwide.This review aims to elucidate the intricate relationship between migraine and stroke, highlighting the role of genetic, vascular, and hormonal factors. Epidemiological evidence shows a positive association between migraine, particularly with aura, and ischemic stroke (IS), though the link to hemorrhagic stroke (HS) remains inconclusive. The shared pathophysiology between migraine and stroke includes cortical spreading depression, endothelial dysfunction, and genetic predispositions, such as mutations linked to conditions like CADASIL and MELAS. Genetic studies indicate that common loci may predispose individuals to both migraine and stroke, while biomarkers such as endothelial microparticles and inflammatory cytokines offer insights into the underlying mechanisms. Additionally, hormonal influences, particularly fluctuations in estrogen levels, significantly impact migraine pathogenesis and stroke risk, highlighting the need for tailored interventions for women. The presence of a patent foramen ovale (PFO) in migraineurs further complicates their risk profile, with device closure showing promise in reducing stroke occurrence. Furthermore, white matter lesions (WMLs) are frequently observed in migraine patients, suggesting potential cognitive and stroke risks. This review hopes to summarize the links between migraine and its associated conditions and ischemic stroke, recognizing the profound implications for clinical management strategies for both disorders. Understanding the complex relationship between migraine and ischemic stroke holds the key to navigating treatment options and preventive interventions to enhance overall patient outcomes.

    Keywords: Migraine Disorders, Migraine with Aura, Migraine without Aura, ischemic stroke, hemorrhagic stroke

    Received: 19 May 2024; Accepted: 03 Jul 2024.

    Copyright: © 2024 Ravi, Osouli Meinagh and Bavarsad Shahripour. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Reza Bavarsad Shahripour, neuroscience, University of California, San Diego, La Jolla, 92093, California, United States

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.