Ischemia-induced migraine from paradoxical cardioembolic stroke.
Although little is known on the pathophysiologic mechanism of migraine-related stroke, the prevailing attitude is that vasoconstriction and activation of clotting factors play a primary role. In 2 female patients presenting with migraine and stroke, risk profiles and history were consistent with this pathophysiologic mechanism. Cerebro- and cardiovascular workup, however, led to a diagnosis of paradoxical cardioembolic stroke through a patent foramen ovale. Since there is hardly any evidence in the literature that migraine acts as a risk factor for stroke on its own, these case reports emphasize the importance of complete cardiovascular evaluation in patients with suspected migrainous stroke.
Ries
S
S
Department of Neurology, Klinikum Mannheim, University of Heidelberg, Germany.
Steinke
W
W
Neff
W
W
Schindlmayr
C
C
Meairs
S
S
Hennerici
M
M
D000293:Adolescent; D000328:Adult; D001783:Blood Flow Velocity / Q000502:physiology; D003937:Diagnosis, Differential; D017548:Echocardiography, Transesophageal; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D002542:Intracranial Embolism and Thrombosis / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D008881:Migraine Disorders / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D012307:Risk Factors; D017585:Ultrasonography, Doppler, Transcranial; D014636:Valsalva Maneuver