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What is it about migraine? Originally considered by most neurologists to be an annoying, if not life-threatening, brain disorder, manifesting as headache and several well-known associated symptoms, the potential phenomenology of migraine has since expanded well beyond its initial borders. Accumulating data over the past 2 decades has provided evidence that migraine is associated with an increased risk of stroke,1 structural brain injury,2 patent foramen ovale,3 and even atherosclerotic cardiac disease.4 Despite the apparent association with other cardiovascular disorders, however, the mechanisms by which migraine either causes or co-associates with them have remained cryptic. It is plausible that prothrombotic, proinflammatory, or other vasoactive peptides released during migraine may damage vascular endothelium, leading to an increased risk of atherosclerosis and vascular events.4 Alternatively, migraine may co-associate with other vascular risk factors, such as hyperlipidemia and hypertension, which in themselves contribute to an increased risk of vascular disease.5
Lee et al.,6 in this issue of Neurology®, provide evidence for another possible connection between migraine and vascular …
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