Complications

The most serious complication of migraine is possible development of an ischaemic stroke:

• migraine is associated with increased risk of ischaemic (but not haemorrhagic) stroke (1)
• a meta-analysis of 14 studies (2) showed that:
  • the relative risk of ischaemic stroke was 2.16 (95% confidence interval 1.89 to 2.48)
  • increase in risk was consistent in people who had migraine with aura (relative risk 2.27, 1.61 to 3.19) and migraine without aura (relative risk 1.83, 1.06 to 3.15)
  • users of oral contraceptives had an approximately eightfold increase in the risk of ischaemic stroke compared with women not taking oral contraceptives
  • the authors concluded that migraine may be a risk factor in developing stroke

Other possible complications include:

• migraine is associated with an increased risk of depression, manic depression, anxiety disorder, and panic disorder
• status migrainosus - a debilitating migraine that lasts for more than 72 hours
• migrainous infarction - a cerebral infarction occuring during the course of a typical attack of migraine with aura. The aura lasts longer than 60 minutes, and neuroimaging shows ischaemic infarction (3)

Reference:

1. Chang, CL et al. Migraine and stoke in young women: case-control study. BMJ 1999; 318:13-18.
2. Etminan M et al. Risk of ischaemic stroke in people with migraine: systematic review and meta-analysis of observational studies. BMJ. 2005 330(7482):63
3. Headache Classification Subcomittee of the International Headache Society. The international classification of headache disorders. 2nd edition. Cephalagia 2004; 24(Suppl 1):1-150.