The relation between migraine and ischemic stroke in 72 young women aged under 45 and 173 controls was investigated at five hospital in Paris and suburbs. A questionnaire based on the International Headache Society’s criteria for headache and migraine was used in telephone interviews. Migraine and ischemic stroke were strongly associated. Migraine was diagnosed in 60% of patients with stroke compared to 30% of controls. Women with migraine had a more than threefold increased risk of ischemic stroke (19 per 100,000 per year) compared with women without migraine (6 per 100,000 per year). The risk of stroke was higher in cases with aura than in those without aura. It was increased for migrainous women who used oral contraceptives or who were heavy smokers (>20 cigarettes/day). [1]

COMMENT. The authors concluded that despite a relatively small risk of ischemic stroke, smoking and the use of oral contraceptives should be discouraged or limited in young women with migraine. It was not known whether the increased risk of stroke related to all young migrainous women or only to a subgroup that remains to be defined.