title: Does a history of migraine affect the rate of thrombolysis in young stroke patients?
abstract: Background. Migraine is prevalent in young patients and a frequent stroke mimic. To distinguish stroke mimics from true stroke can be difficult, and there is a possibility of misdiagnosing a stroke as a migrainous attack in patients with migraine. We aimed to investigate if a history of migraine affects the rate of thrombolytic therapy in young stroke patients. Methods. All patients below 50 years of age admitted in the period 2006-2013 to the Bergen Stroke Centre with acute ischaemic stroke were included. The rate of thrombolytic therapy in patients with migraine was compared to patients with no history of migraine. A multivariate analysis was performed to adjust confounding factors. Results. A total of 170 young stroke patients were enrolled, 49 with migraine and 121 with no migraine. In total, 10.2% of young patients with migraine received thrombolytic therapy, compared with 26.5% of young patients with nomigraine (P = 0.02). Migraine was associated with a low rate of thrombolytic therapy when adjusting for possible confounding factors (OR 0.19 CI: 0.05-0.72, P = 0.02). Conclusion. Migraine is associated with a low rate of thrombolytic therapy in young patients admitted with acute ischaemic stroke. Migraine patients admitted with acute ischaemic stroke are at risk of maltreatment.
authors.affiliation: Department of Neurology, Haukeland University Hospital, PB 1400, 5021 Bergen, Norway ; Institute of Clinical Medicine, University of Bergen, PB 7800, 5020 Bergen, Norway.
authors.forename: Halvor
authors.initials: H
authors.lastname: Oygarden
authors.affiliation: Department of Neurology, Haukeland University Hospital, PB 1400, 5021 Bergen, Norway.
authors.forename: Christopher
authors.initials: C
authors.lastname: Elnan Kvistad
authors.affiliation: Department of Neurology, Haukeland University Hospital, PB 1400, 5021 Bergen, Norway ; Institute of Clinical Medicine, University of Bergen, PB 7800, 5020 Bergen, Norway.
authors.forename: Lars
authors.initials: L
authors.lastname: Thomassen
authors.affiliation: Department of Neurology, Haukeland University Hospital, PB 1400, 5021 Bergen, Norway.
authors.forename: Ulrike
authors.initials: U
authors.lastname: Waje-Andreassen
authors.affiliation: Department of Neurology, Haukeland University Hospital, PB 1400, 5021 Bergen, Norway ; Institute of Clinical Medicine, University of Bergen, PB 7800, 5020 Bergen, Norway.
authors.forename: Halvor
authors.initials: H
authors.lastname: Naess