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Migraine linked with higher risk of stroke after surgery

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Surgical patients with a history of migraines have a greater risk of having a stroke and being re-admitted to hospital, a new study has found.

The finding, published in the British Medical Journal, found the risk was highest for those who have migraines with aura, such as seeing flashing lights and patterns.

“A risk assessment for perioperative ischemic stroke in patients with migraine undergoing surgery may be crucial”

Study authors

Crucially, the findings suggest that migraine should be included in pre-operative risk assessments, said the US researchers.

They looked at data on more 124,000 patients who underwent surgery at Massachusetts General Hospital and two linked community hospitals between January 2007 and August 2014.

Of the 771 patients who had a stroke, 11.5% had a history of migraines, indicating sufferers may be a higher risk of stroke during or after surgery.

The researchers estimated that 2.4 strokes might be expected among every 1,000 surgical patients.

However, they suggested the risk increased to 4.3 out of every 1,000 patients with migraines – 3.9 for those who have migraines without aura and 6.3 for those with migraine aura.

The team also found patients with migraine were more likely to be re-admitted to hospital within 30 days of having surgery.

Up to one fifth of people experience migraines and 20-30% experience migraine aura. Given how common the condition is, the researchers said it was vital clinicians were aware of the heightened risk of stroke linked to surgery.

“Given the high prevalence of migraine in the general population, the migraine-perioperative ischemic stroke association carries public health importance, and physicians should be aware of this increased perioperative risk, particularly in patients with migraine who present without traditional risk factors for stroke,” said the study authors.

“We believe that an individual perioperative risk assessment for perioperative ischemic stroke in patients with migraine undergoing surgery may be crucial,” they added.

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