Migrainous infarction.

Q2 Medicine

Handbook of clinical neurology Pub Date : 2024-01-01 DOI:10.1016/B978-0-12-823357-3.00021-5

Chia-Chun Chiang, Shih-Pin Chen

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Abstract

Migrainous infarction is defined as a migraine attack occurring as migraine with aura, typical of the patient's previous attacks, except that one or more aura symptoms persist for >60min, and neuroimaging demonstrates ischemic infarct in the relevant area. To better understand migrainous infarction, one must disentangle the complex interactions between migraine and stroke. In this chapter, we first discuss the migraine-stroke association in sections including "Increased Risks of Stroke and Subclinical Infarcts in Patients With Migraine," "Migrainous Headache Cooccurring or Triggered by Ischemic Stroke," "Stroke Progression in Patients With Migraine," and "Clinic Conditions Associated With Higher Risks of Both Migraine and Stroke." As an extreme example of migraine-stroke association, the annual incidence of migrainous infarction was reported to be 0.80/100,000/year, with the incidence in females nearly twofold that of male patients. Patients diagnosed with migrainous infarction are typically younger (average age 29-39 in case series), have fewer traditional vascular risk factors, and have more favorable prognosis compared to strokes from traditional risk factors. Thorough evaluation is recommended to rule out other etiologies of stroke. Patients diagnosed with migrainous infarction should receive antiplatelet therapy and migraine preventive therapy to avoid future events. Vasoactive medications, including triptans and ergots, should be avoided.

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偏头痛性脑梗塞

偏头痛性脑梗塞的定义是：偏头痛发作时出现先兆性偏头痛，与患者之前的发作具有典型性，但一种或多种先兆症状持续时间超过60分钟，且神经影像学检查显示相关区域存在缺血性梗塞。为了更好地理解偏头痛性脑梗死，我们必须厘清偏头痛与中风之间复杂的相互作用。在本章中，我们首先讨论偏头痛与中风的关联，包括 "偏头痛患者中风和亚临床梗死风险增加"、"缺血性中风并发或诱发偏头痛"、"偏头痛患者中风进展 "和 "与偏头痛和中风风险均较高相关的临床症状 "等章节。作为偏头痛与中风关联的一个极端例子，据报道，偏头痛性脑梗塞的年发病率为 0.80/100,000/年，女性患者的发病率几乎是男性患者的两倍。确诊为偏头痛性脑梗塞的患者通常较为年轻（病例系列中平均年龄为 29-39 岁），传统的血管风险因素较少，与传统风险因素导致的脑卒中相比，预后更佳。建议进行全面评估以排除其他脑卒中病因。确诊为偏头痛性脑梗塞的患者应接受抗血小板治疗和偏头痛预防治疗，以避免今后再发事件。应避免使用血管活性药物，包括曲坦类药物和麦角类药物。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Handbook of clinical neurology Medicine-Neurology (clinical)

CiteScore

4.10

自引率

0.00%

发文量

302

期刊介绍： The Handbook of Clinical Neurology (HCN) was originally conceived and edited by Pierre Vinken and George Bruyn as a prestigious, multivolume reference work that would cover all the disorders encountered by clinicians and researchers engaged in neurology and allied fields. The first series of the Handbook (Volumes 1-44) was published between 1968 and 1982 and was followed by a second series (Volumes 45-78), guided by the same editors, which concluded in 2002. By that time, the Handbook had come to represent one of the largest scientific works ever published. In 2002, Professors Michael J. Aminoff, François Boller, and Dick F. Swaab took on the responsibility of supervising the third (current) series, the first volumes of which published in 2003. They have designed this series to encompass both clinical neurology and also the basic and clinical neurosciences that are its underpinning. Given the enormity and complexity of the accumulating literature, it is almost impossible to keep abreast of developments in the field, thus providing the raison d''être for the series. The series will thus appeal to clinicians and investigators alike, providing to each an added dimension. Now, more than 140 volumes after it began, the Handbook of Clinical Neurology series has an unparalleled reputation for providing the latest information on fundamental research on the operation of the nervous system in health and disease, comprehensive clinical information on neurological and related disorders, and up-to-date treatment protocols.