title: Migraine and stroke: in search of shared mechanisms.
abstract: BACKGROUND
  Migraine, particularly with aura, increases the risk for ischemic stroke, at least in a subset of patients. The underlying mechanisms are poorly understood and probably multifactorial.
  
  
  METHODS
  We carried out an extended literature review of experimental and clinical evidence supporting the association between migraine and ischemic stroke to identify potential mechanisms that can explain the association.
  
  
  RESULTS
  Observational, imaging and genetic evidence support a link between migraine and ischemic stroke. Based on clinical and experimental data, we propose mechanistic hypotheses to explain the link, such as microembolic triggers of migraine and enhanced sensitivity to ischemic injury in migraineurs.
  
  
  CONCLUSIONS
  We discuss the possible practical implications of clinical and experimental data, such as aggressive risk factor screening and management, stroke prophylaxis and specific acute stroke management in migraineurs. However, evidence from prospective clinical trials is required before modifying the practice in this patient population.
authors.affiliation: Neurovascular Research Laboratory, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, MA, USA Emergency Headache Center, Lariboisiere Hospital, Assistance Publique-Hopitaux de Paris, France DHU NeuroVasc, France.
authors.forename: Jerome
authors.initials: J
authors.lastname: Mawet
authors.affiliation: Inserm Research Center for Epidemiology and Biostatistics (U897), Team Neuroepidemiology, France University of Bordeaux, College of Health Sciences, France Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, MA, USA.
authors.forename: Tobias
authors.initials: T
authors.lastname: Kurth
authors.affiliation: Neurovascular Research Laboratory, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, MA, USA Stroke Service and Neuroscience Intensive Care Unit, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, MA, USA cayata@partners.org.
authors.forename: Cenk
authors.initials: C
authors.lastname: Ayata
mesh_terms: D006801:Humans; D008881:Migraine Disorders / Q000150:complications* / Q000503:physiopathology*; D020521:Stroke / Q000150:complications* / Q000503:physiopathology*
keywords: Migraine; cerebrovascular disease; ischemic stroke; migrainous infarct; spreading depression