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May 2017

Migraine and the Risk of Carotid Artery Dissection in the IPSYS Registry: Are They Related?

Author Affiliations
  • 1Department of Neurology, Cedars-Sinai Medical Center, Los Angeles, California
JAMA Neurol. 2017;74(5):503-504. doi:10.1001/jamaneurol.2016.6008

Stroke incidence is increasing among patients aged 40 to 60 years—faster than in older age cohorts.1,2 Preliminary evidence suggests that ischemic stroke—not hemorrhage or subarachnoid hemorrhage—accounts for the increase.3 Many speculate that increasing incidences of classic vascular risk factors among young patients contribute to the increased incidence of stroke.4 Certainly, we are all aware of the obesity epidemic and continued prevalence of smoking, leading to premature atherosclerosis.3-6 Furthermore, equally relevant causes of stroke in the young include migraine, drug abuse, cervical arterial dissections, patent foramen ovale (PFO), clotting disorders, and a frustratingly large group of “cryptogenic” strokes. More frequent use, and wider availability, of sympathomimetic-containing sports drinks may result in more strokes as well.7,8 Fortunately, current treatments—thrombolysis and thrombectomy—work well in the young, but it would be preferable to prevent stroke.