Do Migraines Increase the Risk for Perioperative Ischemic Stroke?

According to a new study, patients with a history of migraines have an increased risk of perioperative ischemic stroke and for hospital readmission within 30 days after surgery.

The study included 124,558 patients with and without a history of migraines and migraine aura undergoing surgery at the Massachusetts General Hospital and 2 satellite campuses, and compared perioperative ischemic stroke occurrences and hospital readmissions 30 days after surgery between patients with and without migraines. About 54% of participants were women.
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Of the total, 10,179 patients had a history of migraine, 1278 patients had a history of migraine with aura, and 8901 had a history of migraine without aura. Overall, 771 patients had a perioperative ischemic stroke within 30 days after surgery. The highest rate of ischemic stroke occurred in patients who underwent vascular surgery.

The findings showed that patients with migraines were at an increased risk of perioperative ischemic stroke compared with patients without migraines. Patients who had migraine with aura had a higher risk for ischemic stroke than patients with migraine without aura.

For every 1000 patients, the researchers predicted that the absolute risk for perioperative ischemic stroke was 2.4. The risk increased to 3.9 of every 1000 patients in those with migraine without aura and increased to 6.3 of every 1000 patients in those with migraine with aura. In addition, patients with a migraine history had a higher rate of hospital readmission within 30 days after discharge.

These findings indicate that migraines are associated with an increased risk for perioperative ischemic stroke and hospital readmission within 30 days after surgery.

“We suggest that migraine should be included in the perioperative risk assessment,” the researchers concluded.

—Melissa Weiss

Reference:

Timm FP, Houle TT, Grabitz SD, et al. Migraine and risk of perioperative ischemic stroke and hospital readmission: hospital based registry study [published online January 10, 2017]. BMJ. doi:10.1136/bmj.i6635.