The Association between Migraine and Fetal-Type Posterior Cerebral Artery in Patients with Ischemic Stroke

Abstract

<b><i>Objective:</i></b> The aim of the study was to determine if migraine is associated with fetal-type posterior cerebral artery (PCA) in patients with ischemic stroke. <b><i>Method:</i></b> In this cross-sectional study, patients with acute ischemic stroke were enrolled from two hospitals. The history of migraine headache was evaluated during a face-to-face interview. The variants of fetal-type PCA were assessed with MRA, CTA, or DSA. Patients with and without migraine were compared in terms of fetal-type PCA status and other clinic characteristics. Multivariate logistic regression analyses were performed to adjust for confounders and provide risk estimates for observed associations. <b><i>Result:</i></b> In 750 patients qualified for analysis, 85 (11.3%) were determined with migraine. Patients with migraine had a higher proportion of female gender (51.8% vs. 31.0%, <i>p</i> &#x3c; 0.001), hypertension (72.9% vs. 57.7%, <i>p</i> = 0.007), and fetal-type PCA (36.5% vs. 20.1%, <i>p</i> = 0.001), while lower proportion of current smoking (25.9% vs. 38.3%, <i>p</i> = 0.025) than patients without migraine. National Institutes of Health Stroke Scale (NIHSS) score (3 vs. 2, <i>p</i> = 0.016) was also higher in migraineurs than in non-migraineurs. After adjustment for confounders, fetal-type PCA status was independently associated with migraine (odds ratio [OR] = 2.06; 95% confidence interval [CI], 1.25–3.38; <i>p</i> = 0.005). Other factors associated to migraine included female gender (OR = 2.03; 95% CI, 1.13–3.62; <i>p</i> = 0.017), hypertension (OR = 1.97; 95% CI, 1.17–3.34; <i>p</i> = 0.011), and NIHSS score (OR = 1.08; 95% CI, 1.01–1.16; <i>p</i> = 0.018). <b><i>Conclusion:</i></b> Migraine was associated with fetal-type PCA in patients with ischemic stroke. This finding supported the hypothesis that vascular mechanisms get involved in the migraine-stroke association.