Migraine: Complications

The following are the most important diseases or complications that may be contributed to by migraine:

Respiratory system (J00-J99)

  • Bronchial asthma

Eyes and eye appendages (H00-H59)

  • Glaucoma – heterogeneous group of eye diseases that, if untreated, result in a characteristic optic neuropathy (optic nerve disease).

Cardiovascular system (I00-I99).

  • Angina pectoris (“chest tightness”; sudden onset of pain in the region of the heart) or coronary revascularization (removal of an obstacle to passage in occluded blood vessels by surgery with creation of a bypass circuit); 1.73 times risk
  • Apoplexy, ischemic (stroke due to deficiency of blood flow because of vascular occlusion)
    • In migraine attacks with an aura (MA; approximately 30% of migraine patients); other risk factors include age <45 years, female gender, smoking, and oral contraception (“the pill”)
    • Migraine patients regardless of aura: 1.62-fold risk.
    • Perioperative stroke: 1.75-fold increased risk, with a 95 percent confidence interval of 1.39 to 2.21; that is, increase from 2.4 to 4.3 per 1,000 patients; for migraine with aura: 6.3 strokes per 1,000 patients; esp. risk increase for outpatient surgery: 4.02-fold
    • New-onset migraine with aura (MA).
      • Patients <50 years of age: stroke rate 3.04 per 1,000 person-years – mean time to event had been 28 years
      • Patients > 50 years of age: stroke rate 6.67 per 1,000 person-years – to the event it had taken on average just under 5 years
  • Migrainous infarction, i.e., an acute MA attack leads directly to an ischemic infarction.
  • Myocardial infarction (heart attack); 1.39-fold risk.
  • Silent brain infarcts? – Study finds no clustering in migraine with aura (very rare!).
  • Venous thromboembolism (deep vein thrombosis of the legs and pelvis (DVT) and its most dangerous complication, pulmonary embolism (LE)).
  • Atrial fibrillation (VHF) and atrial flutter.

Mouth, esophagus (food pipe), stomach, and intestines (K00-K67; K90-K93).

Psyche – nervous system (F00-F99; G00-G99)

  • Anxiety
  • Dementia
    • 2-fold increased risk: increased incidence for Alzheimer’s disease (24 vs. 10%), less for vascular dementia (dementia caused by blood vessels)
    • According to a prospective cohort study, there is no association between migraine and dementia (without migraine dementia prevalence 18.5% (1821/9955) vs. 16.7% (233/1397) in migraine patients
  • Depression
  • Parkinson’s disease
  • Restless Legs Syndrome
  • Social isolation

Pregnancy, childbirth and puerperium (O00-O99)

  • Birth by sectio (cesarean section) (20%).
  • Hypertensive pregnancy disease (including blood pressure during pregnancy) (50% more common).
  • Infantile complications of women with migraine:
    • Low birth weight by 20%
    • Birth before 37th week of gestation by 21
    • Birth before the 32nd SSW by 35 %.
    • Hospitalization of the child in the first month of life by 11%.
    • Respiratory distress syndrome by 20% febrile convulsions by 27
  • Preeclampsia or eclampsia (tonic-clonic seizures occurring in the context of pregnancy) (42%)

Prognostic factors

  • During acute migraine attacks, white, blue, orange, and red light can intensify headaches in an intensity-dependent manner; green light can lead to attenuation of headaches.