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Migraine and stroke

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https://www.readbyqxmd.com/read/28807784/gabapentin-prevents-cortical-spreading-depolarization-induced-disinhibition
#1
Masoud Mesgari, Johanna Krüger, Christopher Theo Riemer, Maryam Khaleghi Ghadiri, Stjepana Kovac, Ali Gorji
Cortical spreading depolarization (CSD) has an important role in brain diseases such as stroke, subarachnoid hemorrhage, migraine with aura, and epilepsy. Several anti-epileptic drugs (AEDs) are used to treat paroxysmal brain diseases and are thus known to suppress CSD. One of these AEDs is gabapentin (GBP) which has been traditionally used for treatment of some CSD-related neurological diseases. We applied intra- and extracellular recordings to investigate the effect of CSD on inhibitory post synaptic potentials (IPSPs) and synaptic properties of rodent neocortex after application of GBP...
August 12, 2017: Neuroscience
https://www.readbyqxmd.com/read/28806162/combined-hormonal-contraceptives-and-migraine-an-update-on-the-evidence
#2
REVIEW
Anne H Calhoun, Pelin Batur
Combined hormonal contraceptives are contraindicated in women who have migraine with aura, in whom these drugs can increase the risk of ischemic stroke. However, this contraindication is based on data from the 1960s and 1970s, when oral contraceptives contained much higher doses of estrogen. Stroke risk is not significantly increased with today's preparations, many of which contain less than 30 μg of ethinyl estradiol. Further, in continuous regimens, ultra-low-dose formulations--those that contain less than 20 μg of ethinyl estradiol--may help prevent menstrual migraine and reduce the frequency of aura...
August 2017: Cleveland Clinic Journal of Medicine
https://www.readbyqxmd.com/read/28783808/recrudescence-of-deficits-after-stroke-clinical-and-imaging-phenotype-triggers-and-risk-factors
#3
Mehmet A Topcuoglu, Esen Saka, Scott B Silverman, Lee H Schwamm, Aneesh B Singhal
Importance: Reemergence of previous stroke-related deficits (or poststroke recrudescence [PSR]) is an underrecognized and inadequately characterized phenomenon. Objective: To investigate the clinical features, triggers, and risk factors for PSR. Design, Setting, and Participants: This retrospective study incorporated a crossover cohort study to identify triggers and a case-control study to identify risk factors. The study used the Massachusetts General Hospital Research Patient Data Repository to identify patients for the period January 1, 2000, to November 30, 2015, who had a primary or secondary diagnosis of cerebrovascular disease, who underwent magnetic resonance imaging of the brain at least once, and whose inpatient or outpatient clinician note or discharge summary stated the term recrudescence...
August 7, 2017: JAMA Neurology
https://www.readbyqxmd.com/read/28762753/migraine-in-mitochondrial-disorders-prevalence-and-characteristics
#4
Catello Vollono, Guido Primiano, Giacomo Della Marca, Anna Losurdo, Serenella Servidei
Background Migraine is a well-known feature of mitochondrial disorders (MDs). However, no systematic epidemiological data are available in large populations of patients. Aims The aim of this cross-sectional cohort study was to describe the prevalence and migraine characteristics in a large cohort of patients with mitochondrial encephalomyopathies. Methods We studied 93 consecutive patients with characterised MDs referred to our Neuromuscular Unit during a 12-month period. All patients (age range = 16-78 years; 31 men; 58 progressive external ophthalmoplegia [PEO], 12 myoclonic epilepsy with ragged red fibres [MERRF], eight mitochondrial encephalomyopathy, lactic acidosis and stroke-like episodes [MELAS], two mitochondrial neurogastrointestinal encephalomyopathy [MNGIE] and 13 other MDs) underwent a structured diagnostic headache interview using an operational diagnostic tool following the IHS criteria...
January 1, 2017: Cephalalgia: An International Journal of Headache
https://www.readbyqxmd.com/read/28745187/fresh-focus-on-stroke-care
#5
Catharine Sadler
When 36-year-old company director Nathan Ridgard went to the emergency department with an excruciating headache and neck pain he was told he had a severe migraine and was admitted for tests.
July 26, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28738690/magnetic-resonance-imaging-in-children-presenting-migraine-with-aura-association-of-hypoperfusion-detected-by-arterial-spin-labelling-and-vasospasm-on-mr-angiography-findings
#6
Domitille Cadiot, Romain Longuet, Bertrand Bruneau, Catherine Treguier, Aline Carsin-Vu, Isabelle Corouge, Constantin Gomes, Maïa Proisy
Objective A child presenting with a first attack of migraine with aura usually undergoes magnetic resonance imaging (MRI) to rule out stroke. The purpose of this study was to report vascular and brain perfusion findings in children suffering from migraine with aura on time-of-flight MR angiography (TOF-MRA) and MR perfusion imaging using arterial spin labelling (ASL). Methods We retrospectively included all children who had undergone an emergency MRI examination with ASL and TOF-MRA sequences for acute neurological deficit and were given a final diagnosis of migraine with aura...
January 1, 2017: Cephalalgia: An International Journal of Headache
https://www.readbyqxmd.com/read/28727357/-spontaneous-carotid-and-vertebral-dissections
#7
Roman Sztajzel, Fabienne Perren, Patrik Michel
Dissections of the cervical arteries account for approximately 15-20 % of all strokes in young patients. Clinically they present with laterocervical and/or hemicranial pain associated to a Horner syndrome in case of carotid dissection and a posterior cervical pain associated to headache in the occipital area in case of vertebral dissection. A multifactorial origin is often suggested, resulting from the combination of a weakness of the arterial wall, hereditary or not, of environmental factors such minor trauma or a previous infection and also of the presence of a certain number of vascular risk factors such as high blood pressure or migraines...
April 26, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28657698/mental-and-physical-health-conditions-in-us-combat-veterans-results-from-the-national-health-and-resilience-in-veterans-study
#8
Melissa M Thomas, Ilan Harpaz-Rotem, Jack Tsai, Steven M Southwick, Robert H Pietrzak
Objective: To identify sociodemographic and military characteristics of combat-exposed and non-combat-exposed veterans in the United States and to compare rates of mental and physical health conditions in these populations. Methods: Data were analyzed from the National Health and Resilience in Veterans Study (NHRVS), a contemporary, nationally representative survey of 1,480 US veterans conducted September-October 2013. Poststratification weights were applied to analyses to permit generalizability of results to the US veteran population...
June 22, 2017: Primary Care Companion to CNS Disorders
https://www.readbyqxmd.com/read/28646558/neurology-concepts-young-women-and-ischemic-stroke-evaluation-and-management-in-the-emergency-department
#9
Bernard P Chang, Charles Wira, Joseph Miller, Murtaza Akhter, Bradley E Barth, Joshua Willey, Lauren Nentwich, Tracy Madsen
OBJECTIVE: Ischemic stroke is a leading cause of morbidity and mortality worldwide. While the incidence of ischemic stroke is highest in older populations, incidence of ischemic stroke in adults has been rising particularly rapidly among young (e.g. premenopausal) women. The evaluation and timely diagnosis of ischemic stroke in young women presents a challenging situation in the emergency department, due to a range of sex-specific risk factors and to broad differentials. The goals of this concepts paper are to summarize existing knowledge regarding the evaluation and management of young women with ischemic stroke in the acute setting...
June 24, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28645744/reversible-hemispheric-hypoperfusion-in-two-cases-of-smart-syndrome
#10
Karmen Wai, Anna Balabanski, Nicholas Chia, Timothy Kleinig
Stroke-like migraine attacks after radiation therapy (SMART) syndrome manifests as prolonged episodes of cortical dysfunction, years after cranial irradiation. We present two cases demonstrating reversible hemispheric hypoperfusion. Case 1 presented with left hemispheric symptoms following previous similar episodes. CT perfusion (CTP) demonstrated reversible hemispheric hypoperfusion; subsequent investigations were consistent with SMART syndrome. Case 2 presented following the third episode of a hemispheric syndrome with near-identical CTP abnormalities...
June 20, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28643603/stroke-like-migraine-attacks-after-radiation-therapy-syndrome-case-report-and-review-of-the-literature
#11
Achint K Singh, Bundhit Tantiwongkosi, Anna-Marieta Moise, Wilson B Altmeyer
A 26-year-old female presented with vision loss accompanied by migraine-like headaches. A contrast-enhanced magnetic resonance imaging of the brain was performed which revealed findings suggestive of stroke-like migraine attacks after radiation therapy (SMART) syndrome. SMART syndrome is a delayed complication of brain radiation characterized by neurologic symptoms including migraine-like headaches, seizures, and hemispheric impairment. The purpose of this article is to make the readers aware of this rare complication of brain irradiation...
January 1, 2017: Neuroradiology Journal
https://www.readbyqxmd.com/read/28611097/epidemiology-endovascular-treatment-and-prognosis-of-cerebral-venous-thrombosis-us-center-study-of-152-patients
#12
Kristin Salottolo, Jeffrey Wagner, Donald F Frei, David Loy, Richard J Bellon, Kathryn McCarthy, Judd Jensen, Christopher Fanale, David Bar-Or
BACKGROUND: Cerebral venous thrombosis is a rare cause of stroke that poses diagnostic, therapeutic, and prognostic challenges. Mainstay treatment is systemic anticoagulation, but endovascular treatment is increasingly advocated. Our objectives were to describe the epidemiology, treatment, and prognosis of 152 patients with cerebral venous thrombosis. METHODS AND RESULTS: This was a retrospective study of consecutive cerebral venous thrombosis cases from 2006 to 2013 at a comprehensive stroke center through hospital discharge...
June 13, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28608633/asymptomatic-pulmonary-arteriovenous-malformations-in-children-with-hereditary-hemorrhagic-telangiectasia
#13
Ashley M Gefen, Andrew J White
BACKGROUND: Children with Hereditary Hemorrhagic Telangiectasia (HHT) may have pulmonary arteriovenous malformations (AVMs), which can lead to symptoms of shortness of breath, exercise intolerance, clubbing, cyanosis and hemoptysis. However, some patients with pulmonary AVMs may be asymptomatic, placing them at risk for complications such as stroke or brain abscess if they are not identified and treated. This study examines the incidence of signs and symptoms associated with pulmonary AVMs in children with HHT known to have pulmonary AVMs...
September 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/28571630/occipital-transcranial-magnetic-stimulation-discriminates-transient-neurological-symptoms-of-vascular-origin-from-migraine-aura-without-headache
#14
Gilles Naeije, Yannick Fogang, Noémie Ligot, Nicolas Mavroudakis
OBJECTIVES: The diagnosis of transient neurological attacks (TNA) relies on medical history. Transient ischemic attack is often considered until proven otherwise, because of lack of objective paraclinical tools that can help discriminate TIA from differential diagnoses such as migraine aura. This may lead to needless and potentially harmful stroke secondary prevention in many cases. This study aimed at determining the yield of occipital transcranial magnetic stimulation (oTMS) in discriminating TNA of vascular origin from migraine aura without headache (MAWH)...
May 29, 2017: Neurophysiologie Clinique, Clinical Neurophysiology
https://www.readbyqxmd.com/read/28562816/influence-of-hormonal-contraceptives-and-the-occurrence-of-stroke-integrative-review
#15
Adman Câmara Soares Lima, Larissa Castelo Guedes Martins, Marcos Venícios de Oliveira Lopes, Thelma Leite de Araújo, Francisca Elisângela Teixeira Lima, Priscila de Souza Aquino, Escolástica Rejane Ferreira Moura
Objective: To identify scientific evidence regarding the influence of hormonal contraceptive use and the occurrence of stroke. Method: Integrative review of the literature, through database search using the descriptors "contraceptive agents", "contraceptive devices", "contraceptives, Oral" and "Stroke". Original studies in Portuguese, Spanish and English, published in full and available online were included. Studies that did not answer our guiding questions and duplicated studies were excluded...
May 2017: Revista Brasileira de Enfermagem
https://www.readbyqxmd.com/read/28559833/acute-intravenous-calcium-antagonist-for-suspected-hemiplegic-migraine-a-case-story
#16
Charlotte Lützhøft Rath, Jun He, Mette Maria Nordling, Troels Wienecke
Stroke mimics, like attacks of hemiplegic migraine, are challenging in acute stroke evaluation. We present a 28-year-old woman with a suspected hemiplegic migraine attack with left-sided hemiparalysis. Brain CT with perfusion imaging 1 h 54 min after symptom onset revealed hypoperfusion in the right hemisphere. The patient was treated with intravenous recombinant tissue plasminogen activator (rtPA) with no effect. After a subsequent intravenous verapamil infusion, the patient gained full motor function within 10 min...
January 2017: Case Reports in Neurology
https://www.readbyqxmd.com/read/28551302/acute-stroke-differential-diagnosis-stroke-mimics
#17
Pedro Vilela
Stroke mimics (SM) are non-vascular conditions that present with an acute neurological deficit simulating acute ischemic stroke and represent a significant percentage of all acute stroke hospital admissions. The most common clinical SM includes conversion/functional (psychiatric disorder); seizures and postictal paralysis; toxic-metabolic disturbances; brain tumours; infections, and migraine. Imaging is essential for SM recognition, being Diffusion weighted imaging (DWI), perfusion imaging and angiographic studies very useful...
May 5, 2017: European Journal of Radiology
https://www.readbyqxmd.com/read/28536104/development-and-validation-of-qrisk3-risk-prediction-algorithms-to-estimate-future-risk-of-cardiovascular-disease-prospective-cohort-study
#18
Julia Hippisley-Cox, Carol Coupland, Peter Brindle
Objectives To develop and validate updated QRISK3 prediction algorithms to estimate the 10 year risk of cardiovascular disease in women and men accounting for potential new risk factors.Design Prospective open cohort study.Setting General practices in England providing data for the QResearch database.Participants 1309 QResearch general practices in England: 981 practices were used to develop the scores and a separate set of 328 practices were used to validate the scores. 7.89 million patients aged 25-84 years were in the derivation cohort and 2...
May 23, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28527090/stroke-like-attack-first-episode-of-sporadic-hemiplegic-migraine
#19
Enrico Ferrante, Valentina Prone, Marco Longoni, Elio Clemente Agostoni
Hemiplegic migraine (HM) is a rare migraine with aura; it can be familiar or sporadic. A 46-years-old man presented left migraine followed by right hemiparesis with bilateral plantar flexion of cutaneous plantar reflex (CPR). Brain CT and CT-angiography were normal. The next day patient got worse. The EEG showed left fronto-temporal cuspidate delta waves and brain MRI showed a minimal hyperintensity at T2-sequences in the left frontal cortex with a minor representation of the cortical veins at susceptibility weighted imaging sequences...
May 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28527083/shared-mechanisms-of-epilepsy-migraine-and-affective-disorders
#20
Davide Zarcone, Simona Corbetta
Since the nineteenth century several clinical features have been observed in common between migraine and epilepsy (such as episodic attacks, triggering factors, presence of aura, frequent familiarity), but only in recent years researchers have really engaged in finding a common pathogenic mechanism. From studies of disease incidence, we understand how either migraine among patients with epilepsy or epilepsy among migraine patients are more frequent than in the general population. This association may result from a direct causality, by the same environmental risk factors and/or by a common genetic susceptibility...
May 2017: Neurological Sciences
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