Migraine: Does aura require investigation?

Nirosen Vijiaratnam, Daniel Barber, Kai Zheong Lim, Eldho Paul, Matthew Jiang, Benjamin Chosich, Tissa Wijeratne

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Objectives Migraine is a debilitating condition that affects approximately 15% of the general population. It represents a huge proportion of presentations to the emergency department and a significant number of neurology admissions. Patients are often investigated with imaging. This is particularly the case with migraine with aura (MA). The yield of imaging is however low. There is limited information on Australian hospital presentations and utility of imaging. We aimed to analyse the demographics of migraine presentations to our hospital and the yield of imaging in our centre to help guide future approaches to these patients. Patients and methods We retrospectively looked at medical records of patients presenting to the western health from January 2012 to June 2013. Patients were classified as either having migraine with aura or without. Baseline demographics, cardiovascular risk factors and imaging studies (CT brain, MRI brain and carotid Doppler studies) in each group were evaluated. Patients found to have white matter hyperintensities on MRI were further evaluated. Results We found patients with aura were more likely to have hypercholesterolemia (12% vs 7%, p = 0.05). Patients with aura were more likely to be evaluated with imaging (CT brain (70% vs 41% p < 0.0001) and MRI brain (44% vs 17% p < 0.0001)). The patients investigated with imaging had no clinically significant findings. 21% of patients with aura were investigated with carotid Doppler studies. Only 1 patient had an abnormal result. Patients with white matter hyperintensities were older (51 vs 39 years; p < 0.0001) and were more likely to have Hypertension (29% vs 14% p = 0.019), Hypercholesterolemia (29% vs 11% p = 0.003) and T2DM (16% vs 4% p = 0.011). Conclusion We found patients with MA and without aura to be largely similar. We also found imaging in either group to be of almost no clinical value.

Original languageEnglish
Pages (from-to)110-114
Number of pages5
JournalClinical Neurology and Neurosurgery
Volume148
DOIs
Publication statusPublished - 1 Sep 2016

Keywords

  • Aura
  • Imaging
  • Migraine
  • Risk factors

Cite this

Vijiaratnam, Nirosen ; Barber, Daniel ; Lim, Kai Zheong ; Paul, Eldho ; Jiang, Matthew ; Chosich, Benjamin ; Wijeratne, Tissa. / Migraine : Does aura require investigation?. In: Clinical Neurology and Neurosurgery. 2016 ; Vol. 148. pp. 110-114.
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abstract = "Objectives Migraine is a debilitating condition that affects approximately 15{\%} of the general population. It represents a huge proportion of presentations to the emergency department and a significant number of neurology admissions. Patients are often investigated with imaging. This is particularly the case with migraine with aura (MA). The yield of imaging is however low. There is limited information on Australian hospital presentations and utility of imaging. We aimed to analyse the demographics of migraine presentations to our hospital and the yield of imaging in our centre to help guide future approaches to these patients. Patients and methods We retrospectively looked at medical records of patients presenting to the western health from January 2012 to June 2013. Patients were classified as either having migraine with aura or without. Baseline demographics, cardiovascular risk factors and imaging studies (CT brain, MRI brain and carotid Doppler studies) in each group were evaluated. Patients found to have white matter hyperintensities on MRI were further evaluated. Results We found patients with aura were more likely to have hypercholesterolemia (12{\%} vs 7{\%}, p = 0.05). Patients with aura were more likely to be evaluated with imaging (CT brain (70{\%} vs 41{\%} p < 0.0001) and MRI brain (44{\%} vs 17{\%} p < 0.0001)). The patients investigated with imaging had no clinically significant findings. 21{\%} of patients with aura were investigated with carotid Doppler studies. Only 1 patient had an abnormal result. Patients with white matter hyperintensities were older (51 vs 39 years; p < 0.0001) and were more likely to have Hypertension (29{\%} vs 14{\%} p = 0.019), Hypercholesterolemia (29{\%} vs 11{\%} p = 0.003) and T2DM (16{\%} vs 4{\%} p = 0.011). Conclusion We found patients with MA and without aura to be largely similar. We also found imaging in either group to be of almost no clinical value.",
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Vijiaratnam, N, Barber, D, Lim, KZ, Paul, E, Jiang, M, Chosich, B & Wijeratne, T 2016, 'Migraine: Does aura require investigation?' Clinical Neurology and Neurosurgery, vol. 148, pp. 110-114. https://doi.org/10.1016/j.clineuro.2016.07.006

Migraine : Does aura require investigation? / Vijiaratnam, Nirosen; Barber, Daniel; Lim, Kai Zheong; Paul, Eldho; Jiang, Matthew; Chosich, Benjamin; Wijeratne, Tissa.

In: Clinical Neurology and Neurosurgery, Vol. 148, 01.09.2016, p. 110-114.

Research output: Contribution to journalArticleResearchpeer-review

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T1 - Migraine

T2 - Does aura require investigation?

AU - Vijiaratnam, Nirosen

AU - Barber, Daniel

AU - Lim, Kai Zheong

AU - Paul, Eldho

AU - Jiang, Matthew

AU - Chosich, Benjamin

AU - Wijeratne, Tissa

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