Department of Neurology, Leiden University Medical Center, the Netherlands (H.J.A.v.O., M.J.H.W.).
Department of Neurosurgery and Amsterdam Neuroscience, Amsterdam UMC (D.V., B.A.C.).
Stroke. 2022 Jun;53(6):2075-2077. doi: 10.1161/STROKEAHA.121.038350. Epub 2022 May 6.
Young patients with aneurysmal subarachnoid hemorrhage (aSAH) and a history of migraine may have an increased risk of delayed cerebral ischemia. We investigated this potential association in a prospective cohort of aSAH patients under 50 years of age.
In our prospective cohort study, we included patients with aSAH under 50 years of age from 3 hospitals in the Netherlands. We assessed lifetime migraine history with a short screener. Delayed cerebral ischemia was defined as neurological deterioration lasting >1 hour not attributable to other causes by diagnostic workup. Adjustments were made for possible confounders in multivariable Cox regression analyses, and adjusted hazard ratios were calculated.
We included 236 young aSAH patients (mean age, 41 years; 64% women) of whom 44 (19%) had a history of migraine (16 with aura). Patients with aSAH and a history of migraine were not at increased risk of developing delayed cerebral ischemia compared with patients without migraine (25% versus 20%; adjusted hazard ratio, 1.16 [95% CI, 0.57-2.35]). Additionally, no increased risk was found in migraine patients with aura (adjusted hazard ratio, 0.85 [95% CI, 0.30-2.44]) or in women (adjusted hazard ratio, 1.24 [95% CI, 0.58-2.68]).
Patients with aSAH under the age of 50 years with a history of migraine are not at increased risk of delayed cerebral ischemia.
有偏头痛病史的年轻动脉瘤性蛛网膜下腔出血（aSAH）患者可能存在迟发性脑缺血的风险增加。我们在一个 50 岁以下的 aSAH 患者前瞻性队列中研究了这种潜在的相关性。
在我们的前瞻性队列研究中，我们纳入了来自荷兰 3 家医院的 50 岁以下的 aSAH 患者。我们使用简短的筛查器评估了终生偏头痛病史。迟发性脑缺血被定义为持续 >1 小时的神经功能恶化，且通过诊断性检查不能归因于其他原因。在多变量 Cox 回归分析中进行了可能的混杂因素调整，并计算了调整后的危险比。
我们纳入了 236 例年轻的 aSAH 患者（平均年龄 41 岁；64%为女性），其中 44 例（19%）有偏头痛病史（16 例有先兆）。与无偏头痛的患者相比，有偏头痛病史的 aSAH 患者发生迟发性脑缺血的风险并未增加（25%与 20%；调整后的危险比，1.16[95%CI，0.57-2.35]）。此外，有先兆偏头痛患者（调整后的危险比，0.85[95%CI，0.30-2.44]）或女性患者（调整后的危险比，1.24[95%CI，0.58-2.68]）也未发现风险增加。
50 岁以下有偏头痛病史的 aSAH 患者发生迟发性脑缺血的风险没有增加。
