(1) Young female migraineurs should be considered as a target group for stroke prevention and smoking should be discouraged. There is no general contraindication for OC use in migraine without aura, but caution is required in migraine with aura.
(2) There is no specific treatment for migrainous infarct. Ergot derivates and triptans should not be used for migraine treatment after a cerebral infarct. After the migrainous stroke the usual measures of secondary stroke prevention should be taken.
(3) Transoesophageal echocardiography may be considered in migraine with aura to search PFO.
(4) Performing magnetic resonance (MR) imaging of the brain should be considered in migraine with aura.
(5) Whether migraine with aura patients with MR silent lesions should be treated with triptans is still an open question.
(6) Finally, whether antiplatelet agents should be used in migraine with aura preventive treatment is still a matter of debate.
From Neurol Sci. 2004 Oct;25 Suppl 3:S123-5. Migraine and stroke.
Agostoni E, Fumagalli L, Santoro P, Ferrarese C.
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