Posted by Bob Johnson (208.234.124.40) on July 29, 1999 at 11:13:35:
Someone asked about the risk of stroke when having a CH. A search of MEDLINE revealed several studies from the U.S., Italy, and western Europe which addressed this question in regards to migraine.
(As is so often true, there is little research directed exclusively at cluster and so much of our information works on the assumption that what is true of migraine also applies to CH, unless proven to the contrary. Looking at the MEDLINE citations for the last decade shows--very roughly--that there is a 6:1 ratio migraine/cluster citations. We are not part of the "in" crowd re. research!)
Results of these studies were fairly consistent: for women under 45 there is a slightly increased risk of storke when having an attack. Fortunately, the rate of stroke is very low fo ryoung women and so to say that the risk is doubled is not as serious as it first sounds.
Bottom line: between 20% and 40% of strokes in women seemed to develop directly from the attack. (But again--the actual number of strokes from all causes in young women is very low. This is not a high risk problem.)
Wat is useful, however, was the identification of risk factors which women can alter, thereby reducing the chance of stroke. These risk factors are: family history of migraine; use of oral contraceptives, history of high blood pressure (especially if not adequately treated), and smoking.
My own conclusion is that it makes much sense to work hard at finding a treatment/medication which reduces the frequency of CH. Success with this approach would also bring down the risk of CH leading to stroke. Exccept for family history, all other risk factors can be altered.