Circle of Willis variations in migraine patients with ischemic stroke

Brain Behav. 2019 Mar;9(3):e01223. doi: 10.1002/brb3.1223. Epub 2019 Feb 16.

Abstract

Objectives: Migraine is a risk factor for stroke, which might be explained by a higher prevalence in anatomical variants in the circle of Willis (CoW). Here, we compared the presence of CoW variants in patients with stroke with and without migraine.

Materials and methods: Participants were recruited from the prospective Dutch acute Stroke Study. All participants underwent CT angiography on admission. Lifetime migraine history was assessed with a screening questionnaire and confirmed by an interview based on International Classification of Headache Disorders criteria. The CoW was assessed for incompleteness/hypoplasia (any segment <1 mm), for anterior cerebral artery asymmetry (difference > 1/3), and for posterior communicating artery (Pcom) dominance (Pcom-P1 difference > 1/3). Odds ratios with adjustments for age and sex (aOR) were calculated with logistic regression.

Results: We included 646 participants with stroke, of whom 52 had a history of migraine. Of these, 45 (87%) had an incomplete or hypoplastic CoW versus 506 (85%) of the 594 participants without migraine (aOR: 1.47; 95% CI: 0.63-3.44). There were no differences between participants with and without migraine in variations of the anterior or posterior CoW, anterior cerebral artery asymmetry (aOR: 0.86; 95% CI: 0.43-1.74), or Pcom dominance (aOR: 0.64; 95% CI: 0.32-1.30). There were no differences in CoW variations between migraine patients with or without aura.

Conclusion: We found no significant difference in the completeness of the CoW in acute stroke patients with migraine compared to those without.

Keywords: circle of Willis; computed tomography; humans; migraine; neuroimaging; strokes.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Analysis of Variance
  • Brain / blood supply
  • Brain Ischemia* / diagnosis
  • Brain Ischemia* / physiopathology
  • Circle of Willis* / diagnostic imaging
  • Circle of Willis* / pathology
  • Computed Tomography Angiography / methods
  • Female
  • Humans
  • Male
  • Middle Aged
  • Migraine Disorders* / complications
  • Migraine Disorders* / physiopathology
  • Prevalence
  • Prospective Studies
  • Risk Factors
  • Stroke* / complications
  • Stroke* / physiopathology

Associated data

  • GENBANK/NCT00880113