Migrainous visual accompaniments are not rare in late life: the Framingham Study.
نویسندگان
چکیده
BACKGROUND AND PURPOSE Questionnaires to elicit symptoms of transient ischemic attacks (TIAs) may detect late-life transient visual symptoms similar to the visual aura of migraine, often without headache. We determined the frequency, characteristics, and stroke outcome of these symptoms in the Framingham Study. METHODS During 1971-1989, at biennial examinations, 2110 subjects of the Framingham cohort were systematically queried about the occurrence of sudden visual symptoms. RESULTS Visual migrainous symptoms were reported by 1.23% (26/2110) of subjects (1.33% of women and 1.08% of men). In 65% of subjects the episodes were stereotyped, and they began after age 50 years in 77%. Mean +/- SD age at onset of the episodes was 56.2+/-18.7 years. In 58% of subjects the episodes were never accompanied by headaches, and 42% had no headache history. The number of episodes ranged from 1 to 500 and was 10 or more in 69% of subjects. The episodes lasted 15 to 60 minutes in 50% of subjects. Sixty-five percent of the subjects were examined by a study neurologist, and only 19% of them met the criteria of the International Headache Society. Twelve percent of subjects sustained a stroke after the onset of migrainous visual symptoms: a subarachnoid hemorrhage 1 year later, an atherothrombotic brain stem infarct 3 years later, and a cardioembolic stroke 27 years later. In contrast, of 87 subjects with TIAs in the same cohort, 33% developed a stroke (P = 0.030), two thirds within 6 months of TIA onset. CONCLUSIONS Late-life-onset transient visual phenomena similar to the visual aura of migraine are not rare and often occur in the absence of headache. These symptoms appear not to be associated with an increased risk of stroke, and invasive diagnostic procedures or therapeutic measures are generally not indicated.
منابع مشابه
Comments, Opinions, and Reviews Late-Life Migraine Accompaniments — Further Experience
In 1980, 120 cases with late-life migrainous accompaniments resembling transient ischemic attacks were presented. In the present paper, 85 further cases examined in the past five years are analyzed. The findings support the concept advanced previously. In general, the cases are divided into the same categories: visual — 21 cases, visual and paresthesias — 6, visual and speech disturbance — 2, v...
متن کاملLate-life migraine accompaniments--further experience.
In 1980, 120 cases with late-life migrainous accompaniments resembling transient ischemic attacks were presented. In the present paper, 85 further cases examined in the past five years are analyzed. The findings support the concept advanced previously. In general, the cases are divided into the same categories: visual--21 cases, visual and paresthesias--6, visual and speech disturbance--2, visu...
متن کاملCelecoxib or Prednisolone for Treatment of Medication Overuse Headache: A Randomized, Double-Blind Clinical Trial in Migrainous Patients
Background:Treatment of Medication Overuse Headache (MOH) is yet under debate and Celecoxib as a Cyclooxygenase 2 (COX2) -inhibitor has not been tried widely as a pain relief drug for this type of headaches in migrainous patients. Objectives: comparing the efficacy of celecoxib versus prednisolone for withdrawal period of MOH. Materials & Methods: A double-blind, randomized clinical tri...
متن کاملI-30: Late Onset Severe Hemoperitoneum after Transvaginal Oocyte Retrieval: Incidence, Course, and Management
Background Severe ovarian bleeding after transvaginal oocyte retrieval is a rare but potentially life-threatening complication. A late-onset is common and may be associated with an increased risk for ovariectomy. In the present study we analyzed our cases of ovarian bleeding (OB) after oocyte retrieval and compared it with the published cases and studies, including 31 patients. Main outcome mea...
متن کاملCerebral blood flow in migraine accompaniments and vertebrobasilar ischemia.
BACKGROUND AND PURPOSE Transient neurological symptoms of brain stem or occipital lobe origin may be caused by transient ischemic attack in the vertebrobasilar territory (VB-TIA) or late-onset (or late-life) migraine accompaniment (LOMA). It is often clinically difficult to distinguish between VB-TIA and LOMA. METHODS Cerebral blood flow of 23 patients with VB-TIA, 24 with LOMA, and 28 age-ma...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- Stroke
دوره 29 8 شماره
صفحات -
تاریخ انتشار 1998