Vascular Risk in Migraineurs: Interaction of Endothelial and Cortical Excitability Factors

BACKGROUND: Migraine is a common primary headache disorder occurring predominantly in a young, relatively healthy population. RESULTS: There is a growing literature on associations between migraine, especially migraine with aura, and ischemic stroke as well as other vascular events. Migraine as a risk factor for vascular disease and connections between migraine and endothelial, structural, and genetic risk are reviewed. CONCLUSION: There may be an interaction between endothelial dysfunction and cortical spreading depression affecting risk. Patient education and treatment of modifiable risk factors may decrease future vascular events.