Neurology Medical News about migraine headache;middle age and late-life brain infarcts

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Migraine headache in middle age and late-life brain infarcts
JAMA, 06/25/09

Scher AI et al. – Migraine with aura in midlife was associated with late-life prevalence of cerebellar infarct-like lesions on MRI. This association was statistically significant only for women. The finding supports the hypothesis that migraine with aura in midlife is associated with late-life vascular disease in the cerebellum and in women.

Methods

Study of whether pts not reporting headache vs pts reporting migraine symptoms, particularly aura, in midlife are at increased risk of late-life infarct-like lesions found on magnetic resonance imaging (MRI) without consideration of clinical symptoms
Population-based study of 4689 men and women in Reykjavik, Iceland (cohort born 1907-1935; 57% women)
Follow-up since 1967, examination, and interview about migraine symptoms in midlife (mean age, 51 yrs; range, 33-65 yrs)
Brain MRIs between 2002-2006
Pts reporting ≥ 1 headache/mo asked about migraine symptoms: nausea, unilateral location, photophobia, visual disturbance, numbness
Classification of pts with headache: migraine without aura, migraine with aura, or nonmigraine headache
Comprehensive cardiovascular risk assessment at both examinations
Main outcome measure: presence of infarct-like lesions (total) and specifically located in cortical, subcortical, and cerebellar regions

Results

Infarct-like lesions in 39.3% of men and 24.6% of women
On adjustment for age, sex, and follow-up time, increased risk of late-life infarct-like lesions for pts with midlife migraine with aura (361)vs pts not reporting ≥ 1 headache/mo (3243)
This finding specifically reflects an association with cerebellar lesions in women
Migraine without aura and nonmigraine headache not associated with increased risk

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