Migraine, migraine aura, and cervical artery dissection: a systematic review and meta-analysis

Cephalalgia. 2011 Jun;31(8):886-96. doi: 10.1177/0333102411401634. Epub 2011 Apr 21.

Abstract

Objective: We evaluated the current evidence on the association between migraine, including aura status, and cervical artery dissection.

Methods: We performed a systematic review and meta-analysis of studies investigating the association between migraine or migraine subtypes (e.g. migraine with aura) and cervical artery dissection published through October 2010.

Results: We identified five case-control studies investigating the association between migraine and cervical artery dissection. In pooled analysis, migraine doubled the risk of cervical artery dissection (pooled odds ratio [OR]=2.06, 95% confidence interval [CI] 1.33-3.19). All studies allowed evaluation of migraine aura status. While the effect estimate for migraine without aura (pooled OR=1.94, 95% CI 1.21-3.10) was similar to overall migraine, the association was weaker for migraine with aura (pooled OR= 1.50, 95% CI 0.76-2.96). However, there is no evidence that aura status significantly modifies the association between migraine and cervical artery dissection (meta-regression on aura status p= .58). The risk does not appear to differ between women and men; however, only few studies presented gender-specific data. Heterogeneity among studies was low to moderate.

Conclusion: In this meta-analysis migraine is associated with a two-fold increased risk of cervical artery dissection. This risk does not appear to significantly differ by migraine aura status or gender.

Publication types

  • Meta-Analysis
  • Research Support, N.I.H., Extramural
  • Review
  • Systematic Review

MeSH terms

  • Aortic Dissection / etiology*
  • Brain / blood supply*
  • Case-Control Studies
  • Female
  • Humans
  • Male
  • Migraine Disorders / complications*
  • Risk Factors