Abstract Details

Title Infarct Volume in Acute Stroke in Patients with and without a History of Migraine or Aura

Topic Headache

Presentation(s) P06 - (-)

Poster/Presentation
Number 149

Objective

Background BACKGROUND: A history of migraine, particularly with aura, is a risk for stroke. Cortical spreading depression (CSD) is believed to occur both in acute stroke and migraine aura. Animal models suggest that CSD concurrent with ischemic stroke may be associated with larger infarcts. Individuals with migraine may be predisposed to CSD and therefore larger acute infarcts.

Design/Methods DESIGN/METHODS: Patients able to communicate presenting to a single tertiary-care hospital with possible or confirmed acute stroke were interviewed to determine the presence and nature of current or past headache as well as any headache occurring within 24 hours of stroke symptom onset. Volumes of confirmed acute infarcts were measured from diffusion weighted and apparent diffusion coefficient images. A path model was hypothesized based on potential predictors of infarct size including stroke location, prior history of migraine, prior history of aura, and presence of peri-stroke headache.

Results RESULTS: Data from 139 patients were analyzed using IBM SPSS v 20 with alpha set at p < 0.05. Results of the path analysis revealed that history of aura had a significant direct affect on infarct volume. The re-specified model indicated that without controlling for location, the geometric mean (GM) of the infarct volume for those without prior aura was 4.04 cm3 while the GM for those with prior aura was 10.89 cm3 (2.69 times larger) (p < 0.0001). After controlling for stroke location, the GM for those without prior aura was 1.22 cm3 while the GM for those with prior aura was 3.96 cm3 (3.24 times larger) (p = 0.004).

Conclusions CONCLUSIONS: These data show, for the first time, an association between history of aura and larger infarcts. Further studies are needed to confirm this finding and explore its implications.

Authors/Disclosures
Hina N. Dave, MD (Debakey VA hospital) PRESENTER	Dr. Dave has nothing to disclose.
Stephanie J. Nahas, MD, FAAN (Thomas Jefferson University)	Dr. Nahas has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for AbbVie. Dr. Nahas has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Eli Lilly. Dr. Nahas has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Pfizer. Dr. Nahas has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Axsome. Dr. Nahas has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Amneal. Dr. Nahas has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bausch Health. Dr. Nahas has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Ipsen. Dr. Nahas has received publishing royalties from a publication relating to health care. Dr. Nahas has received publishing royalties from a publication relating to health care. Dr. Nahas has received personal compensation in the range of $500-$4,999 for serving as a expert for CME activities with Medscape/WebMD. Dr. Nahas has a non-compensated relationship as a Board Member-at-Large with American Headache Society that is relevant to AAN interests or activities. Dr. Nahas has a non-compensated relationship as a Executive Board Member with The Headache Alliance that is relevant to AAN interests or activities.
Alastair Compston, PhD, FRCP	No disclosure on file

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