Term Paper on "Migraines and Strokes"

Term Paper 6 pages (1964 words) Sources: 1+

[EXCERPT] . . . .

Migraines & Strokes

Migraine and strokes: correlations among women

Strokes are one of the biggest killers of women in America. "Behind heart disease and cancer, stroke is the third largest cause of death in this country and kills roughly 100,000 American women each year." (Women and Stroke)

The correlation between migraine and strokes, especially ischemic strokes, is particularly relevant among the female population. This is due to the fact that women comprise more than 60-70% of the number of migraine sufferers in almost any given study. The nature of and connection between migraine headaches and ischemic strokes will be explored in this paper as well as their specific correlation with regard to women.

The correlation between strokes and migraine

The connection between migraine and strokes is sometimes controversial. Some experts claim that there is very little connection between the two and that there is no intrinsic link between migraine and stroke intensity.

There is no correlation between headache and either the severity or the size of a stroke... Nor is headache a typical presenting symptom in the stroke patient however, stroke patients with headache tend to be younger than stroke patients without headache. There is no relation between stroke-related headache and traditional vascular risk factors such as hypertension, heart disease, or diabetes. (Richman, E. 2000)

However, other studies have found that 'migraine with aura' has a strong correlation with stokes. While there was a low correlation between migraine and hemorrhagic stroke, there was a correlation between migraines and ischemic strokes.

The increased risk was seen for ischemic stroke, caused by blocked blood flow to brain tissue, which results in oxygen deprivation to the brain tissue. However, no relationship was seen between any type of headache and hemorrhagic stroke, caused by bleeding in the brain. (Hecht, B. And Hecht F. 2004)

In a study undertaken at Brigham and Women's Hospital and Harvard Medical School in Boston - involving 39,754 women - it was found that of the 385 strokes documented over a nine-year period, 309 were ischemic, 72 hemorrhagic and 4 undefined. (ibid) Importantly it was also found that of the 385 total strokes, "68 occurred in migraineurs, with 25 occurring in women with aura and 43 in women without aura. Of the 309 ischemic strokes, 57 occurred in migraineurs, 22 in women with migraine with aura and 35 without aura." (ibid)

These findings point to a definite correlation between migraine and stroke in women. A result that stands out in the study is that women with migraine and aura had an increased risk of both total and ischemic stroke, while those with migraine without aura had no increase in stroke risk. Another significant result was that women younger than 55 years were at greatest risk of ischemic stroke. (ibid) the correlation between migraine and stokes is also outlined in a study by Chang et al. - one of the leading studies of its kind.

A history of migraine as defined by International Headache Society criteria was given by 74 of the stroke patients (25.4%) and 96 of the control patients (13.0%). Stroke patients were also more likely to report a history of hypertension, diabetes, heavy smoking, heavy alcohol intake, a family history of early stroke and migraine. Case subjects were also more likely to be current users of oral contraceptives. The overall risk of stroke... In women with a history of migraine was 1.78, but the risk was dramatically different for ischemic stroke (3.54) compared with hemorrhagic stroke (1.1) (Reducing the Risk of Stroke in Women with Migraine. 1999)

The study points out that in many cases there is a significant correlation between ischemic stroke and migraine in women. "Up to 40% of strokes in women with migraine developed directly from a migrainous attack, and around 70% reported a headache within the three days before the stroke." (ibid)

The study also stresses that ischemic strokes are rare in pre-menopausal women but that other factors such as genetic history and smoking can affect this incidence. A further study also indicates that there a danger of migraine leading to stroke for patients in the over forty age category.

One study, "Migraine and Stroke Risk," published in the journal Neurology (Merikangas et al., 1997), said people at age 40 who suffered from migraine were nearly three times as likely to have a stroke compared to people who were migraine-free. (Stroke - Are Migraine Sufferers at Risk of Stroke?)

3. Migraine

Migraine is a neurological disorder which is characterized by severe, repeating headaches. About a third of people with migraine also experience a sensory disturbance called an aura. The relationship of migraine headaches to strokes becomes clearer if we look at a more detailed definition.

A migraine headache is a form of vascular headache. Migraine headache is caused by a combination of vasodilatation (enlargement of blood vessels) and the release of chemicals from nerve fibers that coil around the blood vessels. During a migraine attack, the temporal artery enlarges... Enlargement of the temporal artery stretches the nerves that coil around the artery and cause the nerves to release chemicals. The chemicals cause inflammation, pain, and further enlargement of the artery. The increasing enlargement of the artery magnifies the pain. (Lee D. 2004)

Migraines affect more than 28 million Americans, with females sufferers in the majority - approximately 17% are female as opposed to 6% of males (ibid) it is estimated that one in six American women suffer from migraine. (Migraines. 2000) Despite these relatively high numbers, migraines "still remains largely under treated and under diagnosed. Less than half the sufferers are diagnosed by their doctors." (ibid)

In terms of statistics affecting women in America, migraine accounts for 64% of severe headaches in women and 43% in men. (Cutlip W.D. 1995) the difference between male and female sufferers is revealed in the following study:

The survey revealed that 17.6% of the women and 5.7% of the men met the case-definition for migraine. Using these figures, the authors projected that 18 million women and 5.6 million men in the United States suffer from severe migraine, and an additional 8.7 million women and 2.6 million men experience moderately to severely disabling migraine headaches. As many as 3.4 million women and 1.1 million men experience one or more migraine headaches per month.

(Cutlip, W.D. 1995)

Migraine in women has often been related to perimenopausal change which usually indicates a time of intensified headaches. The female age group which is at highest risk to migraine attacks is those between the ages of 39 and 40. Besides biological aspects such as hormonal changes, pregnancy and PMS, there are other causative factors such as stress and socially related pressure in modern women. Another aspect is that women often hide this affliction. "The lack of public understanding of migraine has conditioned many women to keep their 'problem' to themselves." (New Study Shows Migraine Hits Women Harder)

There are also genetic and racial variations in the number of women sufferers in the United States. "A high incidence of migraines among Caucasians exists in the United States, and evidence suggests that there are racially related differences in genetic vulnerability to headaches."

(Cutlip, W.D. 1995) the symptoms of migraine are headaches which are severe, chronic and recurring.

4. Ischemic stroke

An Ischemic stroke takes place when the blood supply to the brain is disrupted suddenly. A hemorrhagic stroke, on the other hand, occurs when a blood vessel bursts in the brain. This causes blood to seep into the areas surrounding the brain cells. The symptoms are generally easy to diagnose. The patient experiences numbness and weakness unusually to one side of the body, mental confusion, and speech disruption, vision problems, loss of balance and/or coordination. These symptoms are the result of the death of brain cells which no longer receive oxygen and nutrients during the period of the stroke. Stroke is formally diagnosed through various techniques. These include neurological examination, blood tests, CT scans, MRI scans, Doppler ultrasound, and arteriography. (Headache and Migraine Glossary)

The statistics with regard to female patients are alarming. It is seen as one of the "leading cause of serious long-term disability in the United States. Every minute someone in the United States experiences stroke and over the course of a lifetime, four out of every five American families are touched by the incidence of a stroke. For your good health, prevention of stroke should start as early as possible." (Women and Stroke)

The risk of stroke is increased in women nearer the age of menopause and tends to increase by 64% in older women. (ibid) Due to the higher number of women who suffer from migraines, the incidence of those affected by ischemic stroke is increased. "The risk is greatest in women who experience migraine with aura and in those with additional risk factors, such as new persisting headache or new-onset migraine aura. " (WALLING D)

The cause of strokes can be related to aspects other than age such as smoking and lifestyle stress. However, there are a large number… READ MORE

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