Abstract TP175: Migraines and the Risk of Hemorrhagic Stroke

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Background and Objectives: Migraine is a common neurological disorder affecting 38 million people in the United States. Hemorrhagic stroke accounts for 13% of all stroke cases and the risk of having a hemorrhagic stroke is 94 in 100,000 or 0.94%. There are two types of hemorrhagic stroke; intracerebral hemorrhage (ICH) and subarachnoid hemorrhage (SAH). Previous research has investigated the association between migraine and vascular disease, with several studies demonstrating a possible link between migraines and ischemic stroke. The relationship between migraine and hemorrhagic stroke remains unclear.

Methods: A retrospective review from January 2012-December 2014 of hemorrhagic stroke patients (n=3682) from 30 Michigan hospitals using a Get With the Guidelines (GWTG) database was conducted. Stroke subtypes and patient medical histories were examined. This sample set was comprised of 46.95% males and 53.05% females.

Results: It was found that the risk for hemorrhagic stroke increased from 0.94% to 2.12% with a medical history of migraines. The risk of ICH with a history of migraine in this study was 1.41%, while the risk of SAH with a history of migraine was 3.11%. The median age for a hemorrhagic stroke in this sample set was 67 years. A patient with a medical history that included migraines, had a median hemorrhagic stroke age of 55 years. Of these patients with a history of migraine who developed a hemorrhagic stroke, 74.7% were female and 25.3% were male.

Conclusions: This study demonstrated that a higher risk of hemorrhagic stroke is associated with a history of migraines. The median age for an individual with a hemorrhagic stroke and history of migraine was significantly lower (12 years) than the median age of the sample, which indicates that migraines as a risk factor for stroke might be more significant in middle age. Additionally, this risk seemed to impact females much more than males. A limitation of this study is that GWTG Stroke does not include whether the patient has a migraine with or without aura. Migraine with aura has been associated at a higher rate with ischemic stroke than migraine without aura. It would be beneficial for future studies regarding migraine and hemorrhagic stroke to include whether the migraine was associated with or without aura.

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