Anatomic Circle of Willis Variations Equally Common in Migraineurs and Non-Migraineurs

The completeness of the circle of Willis (CoW), a structure for collateral cerebral blood that has common variations in the general population, does not differ between patients with acute stroke with and without migraine, according to a study published in Brain and Behavior.

A total of 646 patients with acute stroke were enrolled from the prospective Dutch acute Stroke Study. Of these patients, a total of 52 individuals had a history of migraine. At time of hospital admission, participants underwent computed tomography angiography.

A short 5‐item migraine in stroke screening questionnaire was used to examine lifetime migraine history, which was confirmed by interview using the International Classification of Headache Disorders criteria.

Researchers evaluated the CoW for incompleteness/hypoplasia (any segment <1 mm), for anterior cerebral artery asymmetry (difference >1/3), and for posterior communicating artery dominance (posterior communicating artery–P1 difference >1/3).

No difference was found between people with stroke patients with migraine vs those without migraine with regard to incomplete or hypoplastic CoW (87% vs 85%, respectively; adjusted odds ratio [aOR], 1.47; 95% CI, 0.63-3.44).

Additionally, there were no differences between patients with vs without migraine in terms of anterior or posterior CoW variations, Pcom dominance (aOR, 0.64; 95% CI, 0.32-1.30), or anterior cerebral artery asymmetry (aOR, 0.86; 95% CI, 0.43-1.74).

No differences were observed between people with migraine with vs without aura in CoW variations. People with migraine with aura, however, were more likely to have an incomplete anterior CoW vs patients without migraine (aOR, 3.22; 95% CI, 1.21-8.59).

Limitations of the study include the potential for recall bias on the migraine screener and that some participants were lost to follow-up assessment.

“Future studies are needed to assess their role in the vascularization of the posterior circulation in patients with migraine and to assess the longitudinal relationship between migraine and CoW morphology,” the researchers concluded.

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Reference

Hamming AM, van Walderveen MAA, Mulder IA, et al; for the Dutch acute Stroke Study (DUST) investigators. Circle of Willis variations in migraine patients with ischemic stroke [published online February 16, 2019]. Brain Behav. doi: 10.1002/brb3.1223

This article originally appeared on Neurology Advisor