Evidence map›Paper›PMID 25754176›Full record

ArticleCephalalgia : an international journal of headache2015

Is migraine a risk factor for pediatric stroke?

Amy A Gelfand, Heather J Fullerton, Alice Jacobson, Stephen Sidney, Peter J Goadsby, Tobias Kurth, Alice Pressman

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Cephalalgia : an international journal of headache, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed, 3 pooled it
3.8field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

18 citing papers in PubMed, 3 syntheses or guidelines pooled it, 48 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Migraine and the risk of stroke: an updated meta-analysis of prospective cohort studies.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2017
    Pooled it
  4. Article
  5. Review
  6. Article
  7. Review
  8. Article
  9. Review
  10. Pediatric Episodic Migraine with Aura: A Unique Entity?Children (Basel, Switzerland) · 2021
    Review
  11. Article
  12. Article
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  14. Article
  15. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 5 institutions in 3 countries.

Amy A GelfandUCSF Headache Center, Department of Neurology, University of California San Francisco, USA Division of Child Neurology, UCSF, USA GelfandA@neuropeds.ucsf.edu.
Heather J FullertonDivision of Child Neurology, UCSF, USA.
Alice JacobsonSutter Health Research Development and Dissemination, USA Kaiser Permanente Northern California, Division of Research Oakland, USA.
Stephen SidneyKaiser Permanente Northern California, Division of Research Oakland, USA.
Peter J GoadsbyUCSF Headache Center, Department of Neurology, University of California San Francisco, USA NIHR-Wellcome Trust Clinical Research Facility, King's College London, UK.
Tobias KurthInserm Research Center for Epidemiology and Biostatistics (U897) - Team Neuroepidemiology, France University of Bordeaux, College of Health Sciences, France.
Alice PressmanSutter Health Research Development and Dissemination, USA Kaiser Permanente Northern California, Division of Research Oakland, USA.
Kaiser Permanente · USInserm · FRNIHR Wellcome Trust Southampton Clinical Research Facility · GBSutter Health · USUniversity of California, San Francisco · US

Funding

Translating discoveries in neurological diseases of infancy and childhoodK12NS001692 · NINDS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI FULLERTON, HEATHER J · 1993 to 2018
$6.4M
Genetics and Comorbidity of MigraineR01NS080863 · NINDS · KAISER FOUNDATION RESEARCH INSTITUTE · PI PRESSMAN, ALICE ROGOT · 2012 to 2014
$979k
NINDS NIH HHS 1R01NS080863-01NINDS NIH HHS K12 NS001692NINDS NIH HHS K12 NS01692NINDS NIH HHS R01 NS080863
6 · The paper itself

Abstract

importanceOur understanding of risk factors for childhood stroke is incomplete. In adults, migraine with aura is associated with a two-fold increase in ischemic stroke risk.

objectiveIn this cohort study we examine the association between migraine and stroke among children in Kaiser Permanente Northern California (KPNC). DESIGN, SETTING, AND

participantsChildren ages 2-17 years who were members of KPNC for ≥6 months between 1997 and 2007 were included. Migraine cohort members had one or more of: an ICD-9 code for migraine, migraine listed as a significant health problem, or a prescription for a migraine-specific medication. The comparison group was children with no evidence of headache.

main outcome measuresMain outcome measures included stroke incidence rates and incidence rate ratios (IR).

resultsAmong the 1,566,952 children within KPNC during the study period, 88,164 had migraine, and 1,323,142 had no evidence of headache. Eight migraineurs had a stroke (three (38%) hemorrhagic; five (63%) ischemic). Eighty strokes occurred in children without headache (53 (66%) hemorrhagic; 27 (34%) ischemic). The ischemic stroke incidence rate was 0.9/100,000 person-years in migraineurs vs. 0.4/100,000 person-years in those without headache; IR 2.0 (95% CI 0.8-5.2). A post-hoc analysis of adolescents (12-17 years) showed an increased risk of ischemic stroke among those with migraine; IR 3.4 (95% CI 1.2-9.5). The hemorrhagic stroke incidence rate was 0.5/100,000 person-years in migraineurs and 0.9/100,000 person-years in those without headache; IR 0.6 (95% CI 0.2-2.0).

conclusionsThere was no statistically significant increase in hemorrhagic or ischemic stroke risk in pediatric migraineurs in this cohort study. A post-hoc analysis found that ischemic stroke risk was significantly elevated in adolescents with migraine. Future studies should focus on identifying risk factors for ischemic stroke among adolescent migraineurs. Based on adult data, we recommend that migraine aura status should be studied as a possible risk factor for ischemic stroke among adolescent migraineurs.

Indexed as

AdolescentChildChild, PreschoolCohort StudiesFemaleHumansMaleMigraine DisordersRetrospective StudiesRisk FactorsStrokeaurachildhood strokeMigrainepediatric stroke

Identifiers

PMID25754176
PMCPMC4564362
OpenAlexW1971826636

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.