Abstract number: ESOC2026A534 prognosis of apparent tias with additional migraine aura-like symptoms: population-based cohort study
Abstract
Abstract Background and aims Although cerebral ischaemia can mimic migraine aura, guidelines discourage diagnosis of TIA if events have some migraine-like features. Moreover, many TIA-services also advise against referral of patients with such events. We did a population-based study of the incidence and prognosis of all patients referred to TIA services with or without migraine-like features. Methods Prospective study (2002-2023) of all patients referred with acute-onset transient neurological symptoms nested within a population-based study of all vascular events in Oxfordshire, UK. Events were classified prior to investigation as guideline-consistent TIA without migraine-like symptoms versus otherwise classical TIA with additional migraine-like features (progressive or positive visual/other symptoms irrespective of headache). Risks of stroke (90-days/10-years) were determined by face-to-face follow-up to 2026 and compared with the stroke incidence rate expected based on age and sex-specific rates in the underlying population. Results Among 2169 eligible patients, 1973 had guideline-consistent TIA without migraine-like features and 196 (9.0%) had an event that would otherwise be guideline-consistent but had additional migraine-like features. The 90-day stroke risk in this group was 3.06% (95%CI = 1.39-6.69) and the age/sex-adjusted 10-year stroke risk was higher than expected in the underlying population (O/E = 4.8, 2.8-7.7, P < 0.0001). The 10-year stroke risk was similar…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 2,169 participants or records.
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