As the presented migraine-related burden is considerable, we hope that our data will increase the awareness among local decision makers in allocating

resources for treatment and research on headache. “
“Migraine increases MAPK Inhibitor Library molecular weight the risk of stroke, particularly in young and otherwise healthy adults. Being the most frequent neurological condition, migraine prevalence is on a par with that of other common stroke risk factors, such as diabetes or hypertension. Several patterns of association have emerged: (1) migraine and stroke share a common association (eg, vasculopathies, patent foramen ovale, or pulmonary A-V malformations); (2) injury to the arterial wall such as acute arterial dissections can present as migraine aura attacks or stroke; (3) strokes rarely develop during a migraine attack, as described for “migrainous stroke.” Increasing experimental evidence suggests that cerebral hyperexcitability and enhanced susceptibility to spreading depolarization, the electrophysiologic event underlying migraine, may serve as a mechanism underlying the migraine-stroke association. Mice carrying human vascular or neuronal migraine mutations exhibit an enhanced susceptibility to spreading depolarization while being particularly vulnerable to cerebral ischemia. The severe stroke phenotype

in migraine mutant mice can be prevented by suppressing spreading depolarization. If confirmed in the clinical setting, inhibiting spreading depolarization might protect migraineurs at stroke risk as well as decrease attacks of migraine. “
“(Headache 2011;51:713-725) Objective.— To investigate selleck kinase inhibitor the effect of low-intensity anticoagulation with warfarin on chronic cluster headache refractory to pharmacological management. Background.— Isolated case reports on induction of remission in patients with intractable chronic cluster headache upon institution

of oral anticoagulant therapy do exist. Nonetheless, evidence from randomized controlled trials on the role of oral anticoagulants in cluster headache is lacking. Methods.— Thirty-four patients with refractory chronic cluster headache were randomized to receive warfarin or placebo for 12 weeks. Warfarin was administered to achieve an international normalized ratio between 1.5 and 1.9. After a washout period of 2 weeks, patients were crossed over from 1 treatment MCE to the other. Status of cluster headache was assessed during both treatment periods. The primary outcome measure was the occurrence of remission lasting ≥4 weeks. Results.— Seventeen (50%) patients underwent remission for ≥4 weeks during the warfarin period vs 4 (11.8%) patients during the placebo period (P = .004). This was associated with absolute risk reduction of 0.38 (95% CI = 0.18-0.58), and number needed to treat of 2.6 (95% CI = 1.7-5.5). The Kaplan–Meier curves for occurrence of remission had a hazard ratio of 5.26 (95% CI = 2.13-13.03, P = .0003).