BACKGROUND Patients with migraine might be more susceptible of spreading depolarizations, which are known to affect vascular and neuronal function and penumbra recovery after stroke. We investigated whether these patients have more severe stroke progression and less favorable outcomes after recanalization therapy. METHODS We included patients from a prospective multicenter ischemic stroke cohort. Lifetime migraine history was based on the International Classification of Headache Disorders II criteria. Patients without confirmed migraine diagnosis were excluded. Patients underwent CT angiography and CT perfusion <9 h of onset and follow-up CT after three days. On admission, presence of a perfusion deficit, infarct core and penumbra volume, and blood brain barrier permeability (BBBP) were assessed. At follow-up we assessed malignant edema, hemorrhagic transformation, and final infarct volume. Outcome at three months was evaluated with the modified Rankin Scale (mRS). We calculated adjusted relative risks (aRR) or difference of means (aB) with regression analyses. RESULTS We included 600 patients of whom 43 had migraine. There were no differences between patients with or without migraine in presence of a perfusion deficit on admission (aRR: 0.98, 95%CI: 0.77-1.25), infarct core volume (aB: -10.8, 95%CI: -27.04-5.51), penumbra volume (aB: -11.6, 95%CI: -26.52-3.38), mean blood brain barrier permeability (aB: 0.08, 95%CI: -3.11-2.96), malignant edema (0% vs. 5%), hemorrhagic transformation (aRR: 0.26, 95%CI: 0.04-1.73), final infarct volume (aB: -14.8, 95%CI: 29.9-0.2) or outcome after recanalization therapy (mRS > 2, aRR: 0.50, 95%CI: 0.21-1.22). CONCLUSION Elderly patients with a history of migraine do not seem to have more severe stroke progression and have similar treatment outcomes compared with patients without migraine.

中文翻译：

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有偏头痛病史的缺血性卒中患者的卒中进展和临床结局。

背景技术偏头痛患者可能更容易扩散去极化，这已知会影响中风后的血管和神经元功能以及半影恢复。我们调查了这些患者在再通治疗后是否有更严重的卒中进展和较差的预后。方法我们纳入了来自前瞻性多中心缺血性卒中队列的患者。终生偏头痛病史是根据国际头痛分类II标准进行的。未确诊为偏头痛的患者被排除在外。患者于发病后9小时进行CT血管造影和CT灌注，并在三天后进行随访CT。入院时，评估是否存在灌注不足，梗塞核心和半影量以及血脑屏障通透性（BBBP）。在随访中，我们评估了恶性水肿，出血性转化，以及最终的梗死体积。用改良的兰金量表（mRS）评估三个月的结果。我们通过回归分析计算了调整后的相对风险（aRR）或均值差异（aB）。结果我们纳入了600例偏头痛患者。入院时出现灌注不足（aRR：0.98，95％CI：0.77-1.25），梗塞核心体积（aB：-10.8，95％CI：-27.04-5.51）时，有或没有偏头痛的患者之间没有差异。 ，半影量（aB：-11.6、95％CI：-26.52-3.38），平均血脑屏障通透性（aB：0.08、95％CI：-3.11-2.96），恶性水肿（0％比5％），出血性转化（aRR：0.26，95％CI：0.04-1.73），最终梗死体积（aB：-14.8，95％CI：29.9-0.2）或再通治疗后的结局（mRS> 2，aRR：0.50，95％CI ：0.21-1.22）。