What is the role of migraine in the etiology of posterior cerebral artery (PCA) stroke?

Updated: Jul 30, 2018
  • Author: Erek K Helseth, MD; Chief Editor: Helmi L Lutsep, MD  more...
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Migraine represents a particular challenge in stroke medicine. Migraine typically affects the posterior circulation, although the mechanisms by which stroke occurs are not known. However, numerous postulated mechanisms exist.

Migraine alone commonly results in focal neurologic deficits, which may include visual loss, language disturbances, vertigo, nausea/vomiting, and other symptoms suggestive of posterior circulation disease (frequently known as complicated or basilar migraine). Furthermore, stroke in the posterior circulation distribution is more commonly associated with headache, occurring in approximately 30% of patients. Therefore, distinguishing between complicated migraine, migrainous cerebral infarction, and stroke with headache may be challenging.

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