The Relationship Between Migraine And Hemorrhagic Stroke:a Meta-analysis

Objective: We used the Meta-analysis to evaluate the relationship between migraine and hemorrhagic stroke, which could provide evidence-based basis for early prevention of hemorrhagic stroke.Methods: We systematically searched the electronic databases including MEDLINE?1966-2015?, EMBASE?1974-2015?, Cochrane library?1996-2015?, China Biology Medicine disc?CBM disc??1978-2015?, China National Knowledge Infrastructure?CNKI??1994-2015?, Wan Fang data?1990-2015?, VIP?1989-2015? from inception to December 31, 2015, using subjects about "Migraine" and "Intracerebral hemorrhage" to retrieve published literature in English and Chinese. The type of literature was case-control study or cohort study. We evaluated all the collected articles by the Newcastle-Ottawa Scale_NOS introduced by the Cochrane collaboration. Extracting the data of adjusted odds ratio, adjusted hazard ratio and adjusted relative risk from the collected studies to make a comprehensive analysis with the method of Meta-analysis. All analyses were performed using Stata SE 12.1 software, odds ratio?OR? was used to estimate effect size and 95% confidence interval?CI? represented each effect size range.Results: We searched a total of 11566 records, finally included 9 studies?5 case-control and 4 cohort studies? in our meta-analysis which were all in English. Meta-analysis results were as follows:1.The overall pooled adjusted effect estimate of hemorrhagic stroke in subjects with any migraine versus no migraine subjects was 1.42?95%CI:1.14-1.76;P=0.002?,the difference was statistically significant;2. Adjusted effect estimates of hemorrhagic stroke in migraine subjects with aura versus no migraine subjects was 1.40?95%CI:0.86-2.27;P=0.178?,the difference was not statistically significant;3. Adjusted effect estimates of hemorrhagic stroke in migraine subjects without aura versus no migraine subjects was 1.25?95%CI:1.07-1.46;P=0.005?,the difference was statistically significant;4. Adjusted effect estimates of hemorrhagic stroke in female migraineurs of any age versus control subjects was 1.44?95%CI:1.13-1.85;P=0.004?,the difference was statistically significant;5. Adjusted effect estimates of hemorrhagic stroke in male migraineurs of any age versus control subjects was 1. 45?95%CI:0.63-3.33;P=0.387?,the difference was not statistically significant;6.Adjusted effect estimates of hemorrhagic stroke in young females?<45years? with migraine versus control subjects was 1.58?95%CI:1.16-2.16;P=0.004?,the difference was statistically significant.Conclusion: Results through the comprehensive Meta-analysis indicate there was increased risk of hemorrhagic stroke in patients with migraine. We also have found the relationship in female or young female migraineurs or migraine patients without aura in subgroup analysis, but the relationship was not found in migraine patients with aura.