Migraine, and especially migraine with aura, is associated with an increased risk of stroke and vascular events; however, the reasons for this association are unclear. Several studies evaluated cerebral autoregulation and vasomotor reactivity in patients with migraine compared with non-migraineurs, with conflicting results. Our narrative review aimed at summarizing their results to find the most reliable evidence in the field. Studies which used visual stimuli to evoke vascular responses consistently showed an increased vascular reactivity in migraineurs compared with non-migraineurs, while studies which used systemic stimuli such as hyper- or hypocapnia showed inconsistent results. Therefore, central neural mechanisms might be more important than peripheral vascular mechanisms in determining the cerebral vascular responses of patients with migraine. However, a large body of evidence supports the existence of peripheral vascular dysfunction in patients with migraine. Further studies are needed to explain the complex interactions between central neural and peripheral vascular mechanisms in determining migraine and its vascular risk. Migraine preventive treatments, and especially the most recent ones with a peripheral action, might provide important insights in this field.

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脑血管反应性和偏头痛与中风的关系：叙述性评论

偏头痛，尤其是先兆偏头痛，会增加中风和血管事件的风险；然而，这种关联的原因尚不清楚。几项研究评估了偏头痛患者与非偏头痛患者的大脑自动调节和血管舒缩反应性，​​但结果相互矛盾。我们的叙述性审查旨在总结他们的结果，以找到该领域最可靠的证据。使用视觉刺激引起血管反应的研究一致表明，与非偏头痛患者相比，偏头痛患者的血管反应性增加，而使用全身刺激（如高碳酸血症或低碳酸血症）的研究则显示出不一致的结果。所以，在决定偏头痛患者的脑血管反应方面，中枢神经机制可能比外周血管机制更重要。然而，大量证据支持偏头痛患者存在外周血管功能障碍。需要进一步的研究来解释在确定偏头痛及其血管风险方面中枢神经和外周血管机制之间的复杂相互作用。偏头痛预防治疗，尤其是最近的具有外围作用的治疗，可能会在该领域提供重要的见解。需要进一步的研究来解释在确定偏头痛及其血管风险方面中枢神经和外周血管机制之间的复杂相互作用。偏头痛预防治疗，尤其是最近的具有外围作用的治疗，可能会在该领域提供重要的见解。需要进一步的研究来解释在确定偏头痛及其血管风险方面中枢神经和外周血管机制之间的复杂相互作用。偏头痛预防治疗，尤其是最近的具有外围作用的治疗，可能会在该领域提供重要的见解。