Migraine and risk of hemorrhagic stroke: a study based on data from general practice.
BACKGROUND
We investigated the association between hemorrhagic stroke and migraine using data from The Health Improvement Network database.


RESULTS
We ascertained 1,797 incident cases of intracerebral hemorrhage (ICH) and 1,340 of subarachnoid hemorrhage (SAH). Density-based sampling was used to select 10,000 controls free from hemorrhagic stroke. Using unconditional logistic regression models, we calculated the risk of hemorrhagic stroke associated with migraine, adjusting for age, sex, calendar year, alcohol, body mass index, hypertension, previous cerebrovascular disease, oral contraceptive use, and health services utilization.The risk (odds ratio [OR]) of ICH among migraineurs was 1.2 (95% confidence interval [CI] 0.9-1.5), and of SAH was (1.2, 95% CI 0.9-1.5). The association with ICH was stronger for migraine diagnosed ≥20 years prior to ICH (OR 1.6, 95% CI 1.0-2.4), but not with SAH (OR 1.1, 95% CI 0.6-2.1). In analyses stratified by migraine type and gender, the OR of ICH in women with migraine with aura was 1.7 (95% CI 0.9-3.4) and the corresponding OR of SAH in women was 1.2 (95% CI 0.6-2.3).


CONCLUSIONS
No clear increased risk of ICH or SAH was observed in migraineurs.
Department of Neurology, Odense University Hospital and Institute of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Sdr Boulevard 29, 5000 Odense, Denmark. dgaist@health.sdu.dk.
David
D
Gaist
Antonio
A
González-Pérez
Messoud
M
Ashina
Luis Alberto García
LA
Rodríguez
D015992:Body Mass Index; D016022:Case-Control Studies; D002543:Cerebral Hemorrhage / Q000453:epidemiology* / Q000209:etiology; D016208:Databases, Factual; D005194:Family Practice; D005260:Female; D058006:General Practice; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000150:complications*; D012306:Risk; D020521:Stroke / Q000453:epidemiology* / Q000209:etiology; D013345:Subarachnoid Hemorrhage / Q000453:epidemiology* / Q000209:etiology