Delayed Cerebral Ischemia After Aneurysmal Subarachnoid Hemorrhage in Young Patients With a History of Migraine

• DOI: 10.1161/strokeaha.121.038350
• Publication Date: 2022-05-06T09:00:25Z
• Authors: Hendrikus J.A. va...; Dagmar Verbaan; Ynte M. Ruigrok; Paul Dennesen; Marcella C.A. Müller; Bert A. Coert; Mervyn D.I. Vergo...; Marieke J.H. Wermer
• Keywords: Adult; Male; subarachnoid hemorrhage; Migraine Disorders; Clinical Neurology; Cerebral Infarction; Middle Aged; Subarachnoid Hemorrhage; Brain Ischemia; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; migraine disorders; middle aged; epilepsy; Humans; Female; Advanced and Specialised Nursing; Prospective Studies; hospitals; Cardiology and Cardiovascular Medicine

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.