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Neurological Sciences

, Volume 40, Issue 1, pp 59–66 | Cite as

Migraine improvement after spontaneous cervical artery dissection the Italian Project on Stroke in Young Adults (IPSYS)

  • Valeria De Giuli
  • Francesca Graziano
  • Andrea Zini
  • Marialuisa Zedde
  • Rosalba Patella
  • Corrado Lodigiani
  • Simona Marcheselli
  • Maria Luisa DeLodovici
  • Maurizio Paciaroni
  • Ilaria Casetta
  • Elisa Giorli
  • Alessandro Adami
  • Massimiliano Braga
  • Carmela Casella
  • Alessia Giossi
  • Giorgio Silvestrelli
  • Lucia Tancredi
  • Enrico Maria Lotti
  • Loris Poli
  • Filomena Caria
  • Valeria Piras
  • Laura Cucurachi
  • Massimo Gamba
  • Mario Grassi
  • Alessandro Padovani
  • Alessandro PezziniEmail author
  • on behalf of the Italian Project on Stroke in Young Adults (IPSYS) Investigators
Original Article
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Abstract

Objective

Whether migraine modifies after spontaneous cervical artery dissection (sCeAD) more than after other stroke etiologic subtypes has never been adequately investigated.

Methods

In the setting of the Italian Project on Stroke in Young Adults (IPSYS), we compared the course of migraine before and after acute brain infarct in a group of migraine patients with sCeAD and a group of migraine patients whose ischemia was due to a cause other than CeAD (non-CeAD IS), matched by sex, age (± 3 years), and migraine subtype.We applied linear mixed models to evaluate pre-event vs post-event changes and differences between sCeAD and non-CeAD IS patients.

Results

Eighty-seven patients per group (migraine without aura/migraine with aura, 67/20) qualified for the analysis. After the acute event, migraine headaches disappeared in 14.0% of CeAD patients vs 0.0% of non-CeAD IS patients (p ≤ 0.001). Migraine frequency (patients suffering at least 1 attack, from 93.1 to 80.5%, p = 0.001), pain intensity (from 6.7 ± 1.7 to 4.6 ± 2.6 in a 0 to 10 pain scale, p ≤ 0.001), and use of acute anti-migraine medications (patients taking at least 1 preparation, from 81.6 to 64.4%, p = 0.007) also improved significantly after CeAD as opposed to that observed after non-CeAD IS.

Conclusion

The spontaneous improvement of migraine after sCeAD reinforces the hypothesis of a pathogenic link between the two conditions.

Keywords

Cervical artery dissection Stroke in young adults Migraine 

Notes

Authors’ contributions

Valeria De Giuli: manuscript drafting/revising, study design, data analysis and interpretation, and data acquisition. All authors: manuscript drafting/revising and data acquisition. Francesca Graziano, Mario Grassi, and Alessandro Pezzini: statistical analysis. Alessandro Pezzini: manuscript drafting/revising, study design, data analysis and interpretation, data acquisition, statistical analysis, and study supervision.

Funding

The Italian Project on Stroke in Young Adults (IPSYS) is supported by a grant from the Associazione per la Lotta alla Trombosi e alle Malattie Cardiovascolari (ALT).

Compliance with ethical standards

All aspects of the study were approved by the Ethics Committee of the coordinating Center (University of Brescia) and then of each study site. Written informed consent was obtained from all patients (or next of kin).

Role of the sponsor

The sponsor had no role in the design and conduct of the study; the collection, management, analysis, and interpretation of the data; the preparation, review or approval of the manuscript; or the decision to submit the manuscript for publication.

Alessandro Pezzini had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

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Copyright information

© Springer-Verlag Italia S.r.l., part of Springer Nature 2018

Authors and Affiliations

  • Valeria De Giuli
    • 1
  • Francesca Graziano
    • 2
  • Andrea Zini
    • 3
  • Marialuisa Zedde
    • 4
  • Rosalba Patella
    • 5
  • Corrado Lodigiani
    • 6
  • Simona Marcheselli
    • 7
  • Maria Luisa DeLodovici
    • 8
  • Maurizio Paciaroni
    • 9
  • Ilaria Casetta
    • 10
  • Elisa Giorli
    • 11
  • Alessandro Adami
    • 12
  • Massimiliano Braga
    • 13
  • Carmela Casella
    • 14
  • Alessia Giossi
    • 15
  • Giorgio Silvestrelli
    • 16
  • Lucia Tancredi
    • 17
  • Enrico Maria Lotti
    • 18
  • Loris Poli
    • 1
  • Filomena Caria
    • 1
  • Valeria Piras
    • 19
  • Laura Cucurachi
    • 20
  • Massimo Gamba
    • 21
  • Mario Grassi
    • 22
  • Alessandro Padovani
    • 1
  • Alessandro Pezzini
    • 1
    Email author return OK on get
  • on behalf of the Italian Project on Stroke in Young Adults (IPSYS) Investigators
  1. 1.Dipartimento di Scienze Cliniche e Sperimentali, Clinica NeurologicaUniversità degli Studi di BresciaBresciaItaly
  2. 2.Centro di Biostatistica ed Epidemiologia Clinica, Facoltà di Medicina e ChirurgiaUniversità di Milano-BicoccaMonzaItaly
  3. 3.Stroke Unit, Clinica Neurologica, Nuovo Ospedale Civile “S. Agostino Estense”, AUSL ModenaModenaItaly
  4. 4.S.C. NeurologiaArcispedale Santa Maria Nuova – IRCCSReggio EmiliaItaly
  5. 5.Stroke Unit, Azienda Ospedaliera Sant’AndreaUniversità “La Sapienza”RomeItaly
  6. 6.Centro TrombosiIRCCS Humanitas Research HospitalRozzano-MilanoItaly
  7. 7.Neurologia d’Urgenza e Stroke UnitIRCCS Humanitas Research HospitalRozzano-MilanoItaly
  8. 8.Unità di Neurologia, Ospedale di CircoloUniversità dell’InsubriaVareseItaly
  9. 9.Stroke Unit, Divisione di Medicina CardiovascolareUniversità di PerugiaPerugiaItaly
  10. 10.Stroke Unit, Divisione di Neurologia, Dipartimento di Neuroscienze e RiabilitazioneAzienda Ospedaliero-Universitaria di FerraraFerraraItaly
  11. 11.Unità di NeurologiaOspedale S. AndreaLa SpeziaItaly
  12. 12.Stroke Center, Dipartimento di NeurologiaOspedale Sacro Cuore NegrarVeronaItaly
  13. 13.U.O.C Neurologia, Stroke UnitASST VimercateVimercateItaly
  14. 14.Dipartimento di Neuroscienze, Scienze Psichiatriche e Anestesiologiche, Clinica NeurologicaUniversità di MessinaMessinaItaly
  15. 15.U.O NeurologiaIstituti OspitalieriCremonaItaly
  16. 16.Stroke Unit, Dipartimento di NeuroscienzeASST MantovaMantovaItaly
  17. 17.U.O. NeurologiaAzienda Ospedaliera Ospedale Sant’AnnaComoItaly
  18. 18.U.O.C. Neurologia, AUSL RomagnaRavennaItaly
  19. 19.Stroke UnitAzienda Ospedaliera “G. Brotzu”CagliariItaly
  20. 20.Stroke Unit, U.O NeurologiaOspedale “S. Chiara”TrentoItaly
  21. 21.Stroke Unit, Neurologia VascolareSpedali Civili di BresciaBresciaItaly
  22. 22.Dipartimento di Scienze del Sistema Nervoso e del Comportamento, Università di Statistica Medica e GenomicaUniversità di PaviaPaviaItaly

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