Headache, cerebrovascular symptoms, and stroke: the Atherosclerosis Risk in Communities Study

Neurology. 2005 May 10;64(9):1573-7. doi: 10.1212/01.WNL.0000158326.31368.04.


Objective: To evaluate the occurrence of stroke/TIA symptoms and ischemic stroke events among those with a lifetime history of migraine or other headaches with some migraine features in a biracial cohort of older adults.

Methods: Participants were 12,750 African-American and white men and women from the Atherosclerosis Risk in Communities Study (1993 to 1995). The participants were queried about their lifetime headache history and characterized using modified International Headache Society diagnostic criteria. Stroke/TIA symptoms were classified using a computerized diagnostic algorithm, and ischemic stroke events were identified and validated using medical records. Multivariate logistic regression was used to assess the relationship between headache types and stroke/TIA symptoms and ischemic stroke events.

Results: Migraine with aura was strongly associated with stroke symptoms (odds ratio [OR] 5.46, 95% CI: 3.64 to 8.18), TIA symptoms (OR 4.28, 95% CI: 3.02 to 6.08), and verified ischemic stroke events (OR 2.81, 95% CI: 1.60 to 4.92). Similarly, other headaches with aura were significantly associated with stroke symptoms (OR 3.68, 95% CI: 2.26 to 5.99) and TIA symptoms (OR 4.53, 95% CI: 3.08 to 6.67). In contrast, the associations for migraine without aura and other headaches without aura were not as consistent or robust.

Conclusions: Migraines and other headaches, particularly those accompanied by aura, were associated with an increased occurrence of stroke/TIA symptoms and ischemic stroke events.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • African Continental Ancestry Group
  • Age Factors
  • Algorithms
  • Cerebrovascular Disorders / diagnosis
  • Cerebrovascular Disorders / epidemiology*
  • Cerebrovascular Disorders / physiopathology
  • Cohort Studies
  • Comorbidity
  • Cross-Sectional Studies
  • Data Collection
  • Diagnosis, Differential
  • European Continental Ancestry Group
  • Female
  • Health Surveys
  • Humans
  • Intracranial Arteriosclerosis / diagnosis
  • Intracranial Arteriosclerosis / epidemiology*
  • Intracranial Arteriosclerosis / physiopathology
  • Ischemic Attack, Transient / epidemiology
  • Male
  • Middle Aged
  • Migraine with Aura / diagnosis
  • Migraine with Aura / epidemiology*
  • Migraine with Aura / physiopathology
  • Sex Factors
  • Stroke / diagnosis
  • Stroke / epidemiology*
  • Stroke / physiopathology
  • Surveys and Questionnaires