Stroke And HBP Found In Pregnant Women With Migraines

Happy couple finding out results of a pregnancy test( — Acccording to a new study, pregnant women who have migraines might have a higher risk haveing a stroke, high blood pressure, and blood clots.

Migraine describes a cluster of symptoms that usually includes a severe throbbing pain on one side of the head accompanied by nausea, vomiting, dizziness or extreme sensitivity to sound, light, touch and smell, according to the Migraine Research Foundation. Women who experienced migraines during pregnancy were 15 times as likely to also suffer a stroke, the study, published online today by British Medical Journal, found.

Stroke is rare in women who are expecting, about four cases for every 100,000 births, “so this relative increase is not as alarming as it might seem,” the researchers, led by Cheryl Bushnell, a neurologist at Wake Forest University in North Carolina, wrote in the paper. Still, doctors treating pregnant women admitted to hospitals with active migraines should help to reduce the risk of vascular ailments and treat pregnancy complications, the researchers said.

“This is very, very interesting,” said Anne MacGregor, director of clinical studies at the Migraine Clinic in London, in an interview. “We just have to be careful about how this is interpreted.”

Because the results are preliminary, women shouldn’t panic, said MacGregor, who wasn’t involved in the research.

Body Changes

The most probable explanation for the link is the interaction between migraines and changes in the body during pregnancy, such as increased blood volume and heart rate, which put more stress on the circulatory system, the study’s authors said. The scientists couldn’t say whether migraines cause the blood-vessel, or vascular, conditions or vice versa.

“Because these data do not allow determination of which came first, migraine or the vascular condition, prospective studies of pregnant women are needed to explore this association further,” the researchers wrote.

The study used a U.S. database of more than 18 million hospital records, identifying almost 34,000 pregnancy-related discharges with a diagnosis of migraine from 2000 to 2003. The researchers then searched the records to establish a connection to vascular complications such as heart disease, high blood pressure and blood clots.

Blood Clots

Migraines tripled the risk of venous blood clots and doubled the risk of heart disease, the study found. Women with vascular risk factors including diabetes, high blood pressure and cigarette smoking were also strongly linked to migraines.

The study only picked up a subset of afflicted patients, and may not reflect the actual situation because migraine often disappears in pregnancy, MacGregor said. Symptoms of blood-vessel conditions may have been misdiagnosed.

Migraine headache occurs in up to 26 percent of women of childbearing age and one-third of women between the ages of 35 and 39, the study said. Although very common in this age group, little is known about the prevalence of migraine during pregnancy.

The study won’t change how doctors treat their migraine patients, MacGregor said.

“This will not change clinical practice,” she said. “The strength is not there.”

Chronic Headaches & Migraines' New Treatments

sick woman getting out of bed( — Migraines and chronic headaches are wide-spread phenomena.

Twelve percent of the population, three quarters of them women, suffer at least occasionally from migraines and about 5 percent from chronic headaches. New effective methods of treatment were presented at the Congress of the European Neurological Society (ENS) in Rhodos. According to Greek researchers, migraine sufferers can eliminate symptoms altogether if they take higher doses of anti-migraine medicine for a longer period of time than is now customary. Another team of researchers has found that certain psychopharmaceuticals could serve as a new therapy option for persistent chronic headaches.

Twelve percent of the population, three quarters of them women, suffer at least bouts of migraines, that much-feared type of paroxysmal pulsating headache that generally occurs in just one half of the skull and is accompanied by unpleasant symptoms like nausea and vomiting, dizziness or sensitivity to light and sound.

New tools that could relieve these discomforts for millions of people were just presented at the annual Congress of the European Neurology Society (ENS), held this year on the Greek island of Rhodos from June 16 to 20 June.

The new findings are from a group of researchers led by the psychiatrist Dr. Nikolaos Kouroumalos from the Second Department of Neurology of the General Hospital in Chania on the Greek island of Crete: “In treating migraines, optimizing the effect of already available agents is at least as important a task as developing new substances.”

Symptoms Eliminated with a Different Rhythm of Preventive Drug Therapy The experts have in fact achieved a breakthrough in the effectiveness of preventive therapies. The standard procedure today is to give migraine patients preventive drug therapy at a dose that just suffices to protect them from further attacks or at least to stabilize their recovery. To avoid habituation effects and side-effects, this therapy is successively reduced after a time and finally ended (gradual reduction of the dose to zero). Dr. Kouroumalos: “As a result, most patients suffer a recurrence or worsening of migraine attacks after a certain time and the preventive therapy has to be started over from the beginning again. Our idea was to resume the preventive treatment after a break of two months and administer the previous maximum dose. This dose was then reduced after four weeks and, after a total of six weeks, another break in treatment occurred, this time lasting three months, and so forth until we arrived at a six-month cycle that we constantly repeated for a minimum of three years. Thereafter it was eventually continued according to each patient’s needs.

The approach was a definite success. By regularly “reviving” the preventive therapy, the researchers fully maintained the desired effect of bringing about an end to migraine attacks or at least to reduce their extent over the 24 to 36 month period of observation.

Psychopharmaceuticals Bring Relief from Chronic Headache Pain Four to five percent of the population suffers from chronic headaches. This condition is defined as headaches occurring on average on at least 15 days of the previous three months. They have the disadvantage of having widely diverging causes and of thus requiring widely diverging drugs for treatment.

Dr. Kouroumalos and his team administered neuroleptic drugs, i.e. drugs that are actually used for treating psychoses, to patients who had failed to respond to several attempts of conventional preventive therapy. The retrospective study involved the files of 20 patients who had tried traditional therapy with at least three different migraine agents which did not avail. Half of them were then treated with the conventional neuroleptic Perphenazine and the other half with the atypical neuroleptic Olanzapine.

Both substances brought dramatic relief from headache pain, with Olanzapine doing so to an even greater extent than Perphenazine. “However,” Dr. Nikolaos Kouroumalos explained, “more patients broke off the treatment with Olanzapine.” The atypical antipsychotic causes fewer motor disturbances than its conventional counterpart but is associated with greater weight gains than is the case with conventional neuroleptics. This side-effect is less significant medically but for many patients, it was too high a price to pay for the peace and quiet in their heads.–