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Factors associated with migraine aura mimicking stroke in code stroke.

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Title: Factors associated with migraine aura mimicking stroke in code stroke.
Authors: Macias-Gómez, Adrià (AUTHOR), Suárez-Pérez, Antoni (AUTHOR), Rodríguez-Campello, Ana (AUTHOR), Giralt-Steinhauer, Eva (AUTHOR), Moreira, Antía (AUTHOR), Guisado-Alonso, Daniel (AUTHOR), Capellades, Jaume (AUTHOR), Fernández-Pérez, Isabel (AUTHOR), Jiménez-Conde, Jordi (AUTHOR), Rey, Lucía (AUTHOR), Jiménez-Balado, Joan (AUTHOR), Roquer, Jaume (AUTHOR), Ois, Ángel (AUTHOR), Cuadrado-Godia, Elisa (AUTHOR)
Source: Neurological Sciences. Jun2023, Vol. 44 Issue 6, p2113-2120. 8p. 1 Color Photograph, 1 Diagram, 2 Charts, 1 Graph.
Subjects: Migraine aura, Ischemic stroke, Logistic regression analysis, Stroke patients, Secondary prevention
Abstract: Introduction: Migraine with aura (MA) is a frequent stroke simulator that can lead to erroneous diagnosis and subsequent unnecessary acute or secondary prevention treatments. We analyzed clinical and laboratory data of migraine with aura and ischemic stroke patients to detect differences that could help in the diagnosis. Methods: Retrospective analysis of a consecutive register of code strokes between January 2005 and June 2020. Diagnosis of ischemic stroke or MA was collected. Multivariable logistic regression analyses were performed to test associations between clinical and blood data with ischemic stroke. Results: Of 3140 code strokes, 2424 (77.2%) were ischemic strokes and 34 (1.1%) were MA. Migraine cases were younger, more frequently females and with lower prevalence of vascular risk factors. Initial NIHSS was lower in MA cases, but no differences were seen in fibrinolysis rate (30%). Blood test showed lower levels of glucose, D-dimer, and fibrinogen in MA cases. Multivariable model showed and independent association for ischemic stroke with age [OR, (95%CI): 1.09, (1.07–1.12, p < 0.001], male sex [OR, (95%CI): 4.47, (3.80–5.13), p < 0.001], initial NIHSS [OR, (95%CI): 1.21, (1.07–1.34), p < 0.01], and fibrinogen levels [OR, (95%CI): 1.01, (1.00–1.01), p < 0.05]. A model including sex male OR: 3.55 [2.882; 4.598], p < 0.001, and cutoff points (age > 65, OR: 7.953 [7.256; 8.649], p < 0.001, NIHSS > 6, OR: 3.740 [2.882; 4.598], p < 0.01, and fibrinogen > 400 mg/dL, OR: 2.988 [2.290; 3.686], p < 0.01) showed a good global discrimination capability AUC = 0.89 (95%CI: 0.88–0.94). Conclusions: In code stroke, a model including age, sex, NIHSS, and fibrinogen showed a good discrimination capability to differentiate between MA and Ischemic stroke. Whether these variables can be implemented in a diagnostic rule should be tested in future studies. [ABSTRACT FROM AUTHOR]
Copyright of Neurological Sciences is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Factors associated with migraine aura mimicking stroke in code stroke.
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  Data: &lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Macias-G&#243;mez%2C+Adri&#224;%22&quot;&gt;Macias-G&#243;mez, Adri&#224;&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Su&#225;rez-P&#233;rez%2C+Antoni%22&quot;&gt;Su&#225;rez-P&#233;rez, Antoni&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Rodr&#237;guez-Campello%2C+Ana%22&quot;&gt;Rodr&#237;guez-Campello, Ana&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Giralt-Steinhauer%2C+Eva%22&quot;&gt;Giralt-Steinhauer, Eva&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Moreira%2C+Ant&#237;a%22&quot;&gt;Moreira, Ant&#237;a&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Guisado-Alonso%2C+Daniel%22&quot;&gt;Guisado-Alonso, Daniel&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Capellades%2C+Jaume%22&quot;&gt;Capellades, Jaume&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Fern&#225;ndez-P&#233;rez%2C+Isabel%22&quot;&gt;Fern&#225;ndez-P&#233;rez, Isabel&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Jim&#233;nez-Conde%2C+Jordi%22&quot;&gt;Jim&#233;nez-Conde, Jordi&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Rey%2C+Luc&#237;a%22&quot;&gt;Rey, Luc&#237;a&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Jim&#233;nez-Balado%2C+Joan%22&quot;&gt;Jim&#233;nez-Balado, Joan&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Roquer%2C+Jaume%22&quot;&gt;Roquer, Jaume&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Ois%2C+&#193;ngel%22&quot;&gt;Ois, &#193;ngel&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Cuadrado-Godia%2C+Elisa%22&quot;&gt;Cuadrado-Godia, Elisa&lt;/searchLink&gt; (AUTHOR)
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  Data: &lt;searchLink fieldCode=&quot;JN&quot; term=&quot;%22Neurological+Sciences%22&quot;&gt;Neurological Sciences&lt;/searchLink&gt;. Jun2023, Vol. 44 Issue 6, p2113-2120. 8p. 1 Color Photograph, 1 Diagram, 2 Charts, 1 Graph.
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  Data: &lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Migraine+aura%22&quot;&gt;Migraine aura&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Ischemic+stroke%22&quot;&gt;Ischemic stroke&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Logistic+regression+analysis%22&quot;&gt;Logistic regression analysis&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Stroke+patients%22&quot;&gt;Stroke patients&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Secondary+prevention%22&quot;&gt;Secondary prevention&lt;/searchLink&gt;
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  Data: Introduction: Migraine with aura (MA) is a frequent stroke simulator that can lead to erroneous diagnosis and subsequent unnecessary acute or secondary prevention treatments. We analyzed clinical and laboratory data of migraine with aura and ischemic stroke patients to detect differences that could help in the diagnosis. Methods: Retrospective analysis of a consecutive register of code strokes between January 2005 and June 2020. Diagnosis of ischemic stroke or MA was collected. Multivariable logistic regression analyses were performed to test associations between clinical and blood data with ischemic stroke. Results: Of 3140 code strokes, 2424 (77.2%) were ischemic strokes and 34 (1.1%) were MA. Migraine cases were younger, more frequently females and with lower prevalence of vascular risk factors. Initial NIHSS was lower in MA cases, but no differences were seen in fibrinolysis rate (30%). Blood test showed lower levels of glucose, D-dimer, and fibrinogen in MA cases. Multivariable model showed and independent association for ischemic stroke with age [OR, (95%CI): 1.09, (1.07–1.12, p &lt; 0.001], male sex [OR, (95%CI): 4.47, (3.80–5.13), p &lt; 0.001], initial NIHSS [OR, (95%CI): 1.21, (1.07–1.34), p &lt; 0.01], and fibrinogen levels [OR, (95%CI): 1.01, (1.00–1.01), p &lt; 0.05]. A model including sex male OR: 3.55 [2.882; 4.598], p &lt; 0.001, and cutoff points (age &gt; 65, OR: 7.953 [7.256; 8.649], p &lt; 0.001, NIHSS &gt; 6, OR: 3.740 [2.882; 4.598], p &lt; 0.01, and fibrinogen &gt; 400 mg/dL, OR: 2.988 [2.290; 3.686], p &lt; 0.01) showed a good global discrimination capability AUC = 0.89 (95%CI: 0.88–0.94). Conclusions: In code stroke, a model including age, sex, NIHSS, and fibrinogen showed a good discrimination capability to differentiate between MA and Ischemic stroke. Whether these variables can be implemented in a diagnostic rule should be tested in future studies. [ABSTRACT FROM AUTHOR]
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  Data: &lt;i&gt;Copyright of Neurological Sciences is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder&#39;s express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.&lt;/i&gt; (Copyright applies to all Abstracts.)
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        Value: 10.1007/s10072-023-06641-y
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        Text: English
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      – SubjectFull: Migraine aura
        Type: general
      – SubjectFull: Ischemic stroke
        Type: general
      – SubjectFull: Logistic regression analysis
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      – SubjectFull: Stroke patients
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              Text: Jun2023
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