Spontaneous cervical artery dissection (CEAD) is a frequent cause of ischemic stroke (IS) in young and middle-aged adults. Some studies have reported a higher prevalence of migraines in patients with CEAD. This study evaluated the association between migraine and spontaneous CEAD.

Data were derived from the Italian Project on Stroke at Young Age, a countrywide network of neurologic centers. The subjects were patients with first-ever acute stroke, 18 to 45 years of age, consecutively admitted to 126 hospitals between January 1, 2000, and June 30, 2015. Risk factors for premature cerebral ischemia were documented, including hypertension, diabetes, cigarette smoking, hypercholesterolemia and migraine. The CEAD was categorized as traumatic or nontraumatic.

Of the 2，485 targeted individuals, 13.4% had a diagnosis of IS secondary to CEAD (CEAD IS) and 86.6% had a diagnosis of IS due to other causes (non-CEAD IS). Migraine was found to be more common in the subgroup of patients with CEAD IS (P＝0.01). After adjusting for other risk factors, migraine without aura was significantly associated with CEAD IS, with no such association found in patients with migraine with aura.

This large cohort study of patients with ischemic stroke, ages 18 to 45 years, found an association between migraine headaches, especially those without aura, and spontaneous cervical artery dissection.