Anticardiolipin Antibodies and Migraine-related Strokes

We read the excellent review by Levine and Welch1 on neurologic disease associated with antiphospholipid antibodies with interest. They suggest more than a chance association between antiphospholipid antibodies and migraine. We have studied the incidence of IgM and IgG anticardiolipin antibodies (ACAs) in an enzyme-linked immunosorbent solid-phase assay in 18 patients with migraine-related strokes. The following criteria had to be met for inclusion in the study: (1) there was a clear history of migraine attacks preceding or following the stroke; (2) a neurologic deficit occurred in conjunction with headache; (3) the patient's neurologic deficit must have lasted longer than 24 hours; (4) evidence of an ischemic infarct as demonstrated by computed tomographic findings or magnetic resonance imaging; and (5) no other mechanism of brain infarction was evident from the history, examination results, or available laboratory data. Twelve patients were female.