Delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage in young patients with a history of migraine

Os, H.J.A. van; Verbaan, D.; Ruigrok, Y.M.; Dennesen, P.; Muller, M.C.A.; Coert, B.A.; ... ; Wermer, M.J.H. (2022)

Article / Letter to editor

Background: Young patients with aneurysmal subarachnoid hemorrhage (aSAH) and a history of migraine may have an increased risk of delayed cerebral ischemia. We investigated this potential association in a prospective cohort of aSAH patients under 50 years of age. Methods: In our prospective cohort study, we included patients with aSAH under 50 years of age from 3 hospitals in the Netherlands. We assessed lifetime migraine history with a short screener. Delayed cerebral ischemia was defined as neurological deterioration lasting >1 hour not attributable to other causes by diagnostic workup. Adjustments were made for possible confounders in multivariable Cox regression analyses, and adjusted hazard ratios were calculated. Results: We included 236 young aSAH patients (mean age, 41 years; 64% women) of whom 44 (19%) had a history of migraine (16 with aura). Patients with aSAH and a history of migraine were not at increased risk of developing delayed cerebral ischemia compared with patients without migraine (25% versus 20%; adjusted hazard ratio, 1.16 [95% CI, 0.57-2.35]). Additionally, no increased risk was found in migraine patients with aura (adjusted hazard ratio, 0.85 [95% CI, 0.30-2.44]) or in women (adjusted hazard ratio, 1.24 [95% CI, 0.58-2.68]). Conclusions: Patients with aSAH under the age of 50 years with a history of migraine are not at increased risk of delayed cerebral ischemia.

• epilepsy
• hospitals
• middle aged
• migraine disorders
• subarachnoid hemorrhage

• All authors: Os, H.J.A. van; Verbaan, D.; Ruigrok, Y.M.; Dennesen, P.; Muller, M.C.A.; Coert, B.A.; Vergouwen, M.D.I.; Wermer, M.J.H.
• Date: 2022-06-01
• Journal: Stroke
• Volume: 53
• Issue: 6
• Pages: 2075 - 2077
• DOI: doi:10.1161/STROKEAHA.121.038350