0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Correspondence |

A Questionable Cause of Intracerebral Hemorrhage

Charles C. Esenwa, MD; Mitchell S. V. Elkind, MD, MS
JAMA Neurol. 2013;70(5):653-654. doi:10.1001/jamaneurol.2013.272.
Text Size: A A A
Published online

Extract

In their recent article, Gokhale and colleagues1 described a man with a history of migraines who experienced an intracerebral hemorrhage (ICH). They claimed that this was an example of the amorphous entity termed migraine-associated ICH. However, the differential for an angiogram-negative lobar ICH is wide. It includes hypertensive hemorrhage, cerebral amyloid angiopathy, vascular malformation, aneurysmal rupture, cerebral vein thrombosis, coagulopathy, bleeding tumor, and drugs. There are also other genetic and lifestyle risk factors, of which migraine is not one.2 To our knowledge, there is in fact only 1 prospective study that supports the authors' conclusion. In the Women's Health Study, Kurth and colleagues3 found that women with a history of migraine with aura had an absolute risk increase of 0.003% (hazard ratio, 2.3) for ICH. Because of the low attributable risk, the authors explicitly acknowledged that the study did not provide definitive evidence of association. There is no evidence to support the diagnosis in men.

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

First Page Preview

View Large
First page PDF preview

First Page Preview

View Large
First page PDF preview

Figures

Tables

References

Correspondence

May 1, 2013
JAMA Neurol. 2013;70(5):653-654. doi:10.1001/jamaneurol.2013.21.
CME
Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections
PubMed Articles
[Neurosyphilis in clinical practice]. Klin Med (Mosk) 2014;92(4):51-3.
Jobs
JAMAevidence.com

The Rational Clinical Examination
Quick Reference

The Rational Clinical Examination
Make the Diagnosis: Does This Patient Have a Hemorrhagic Stroke?

brightcove.createExperiences();