Case-control study of migraine and risk of ischaemic stroke in young women.
OBJECTIVE
To determine whether migraine is a risk factor for ischaemic stroke in young women.


METHODS
A case-control study.


METHODS
Five hospitals in Paris and suburbs.


METHODS
72 women aged under 45 with ischaemic stroke and 173 controls randomly selected from women hospitalised in the same centres.


METHODS
Ischaemic stroke confirmed by cerebral computerised tomography or magnetic resonance imaging; history of headache recorded with structured interview, and diagnosis of migraine assessed by reproducibility study.


RESULTS
Ischaemic stroke was strongly associated with migraine, both migraine without aura (odds ratio 3.0 (95% confidence interval 1.5 to 5.8)) and migraine with aura (odds ratio 6.2 (2.1 to 18.0)). The risk of ischaemic stroke was substantially increased for migrainous women who were using oral contraceptives (odds ratio 13.9) or who were heavy smokers (> or = 20 cigarettes/day) (odds ratio 10.2).


CONCLUSIONS
These results indicate an independent association between migraine and the risk of ischaemic stroke in young women. Although the absolute risk of ischaemic stroke in young women with migraine is low, the reduction of known risk factors for stroke, in particular smoking and use of oral contraceptives, should be considered in this group.
Tzourio
C
C
INSERM U 360, Recherches Epidémiologiques en Neurologie et Psychopathologie, Villejuif, France.
Tehindrazanarivelo
A
A
Iglésias
S
S
Alpérovitch
A
A
Chedru
F
F
d'Anglejan-Chatillon
J
J
Bousser
M G
MG
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D016022:Case-Control Studies; D002561:Cerebrovascular Disorders / Q000209:etiology*; D003276:Contraceptives, Oral / Q000009:adverse effects; D005260:Female; D006801:Humans; D008881:Migraine Disorders / Q000150:complications*; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects
D003276:Contraceptives, Oral