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Systematic review and meta-analysis
Migraine is a marker for risk of both ischaemic and haemorrhagic stroke
  1. Tobias Kurth
  1. Inserm Research Center for Epidemiology and Biostatistics (U897)—Team Neuroepidemiology and University of Bordeaux, Bordeaux, France
  1. Correspondence to: Dr Tobias Kurth, Inserm Research Center for Epidemiology and Biostatistics (U897)—Team Neuroepidemiology, University of Bordeaux, 146 rue Léo Saignat—CS61292, Bordeaux 33076, France; tobias.kurth{at}u-bordeaux.fr

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Context

Migraine is one of the most common neurological diseases.1 It is defined by specific pain characteristics and associated features.2 In about one-third of patients transient neurological symptoms known as migraine aura occur, mainly affecting the visual system.

Migraine is primarily understood as a disorder of the brain, but strong links to the vascular system exist. Migraine, particularly migraine with aura, has been firmly associated with increased risk of ischaemic stroke.3 While precise mechanisms explaining the link between migraine and ischaemic stroke remain unclear, associations between migraine and major vascular risk factors, vessel wall pathologies and small vessel disease exist,4 making it plausible that migraine is also associated with haemorrhagic stroke. This study summarises the available evidence.

Methods

Sacco and colleagues identified case–control and cohort studies evaluating the association between migraine and haemorrhagic stroke (both intracerebral haemorrhage …

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