{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T15:45:42Z","timestamp":1792683942952,"version":"4.5.0"},"reference-count":17,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,2,27]],"date-time":"2024-02-27T00:00:00Z","timestamp":1708992000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004362","name":"Schweizerische Herzstiftung","doi-asserted-by":"publisher","award":["FF21070"],"award-info":[{"award-number":["FF21070"]}],"id":[{"id":"10.13039\/501100004362","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["headachejournal.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Headache"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Sometimes migraine aura changes from attack to attack, raising the question of whether the change is heralding an ischemic stroke or an unusual aura. Differentiating unusual migraine aura from the onset of an acute ischemic stroke in patients with migraine with aura (MwA) can be challenging.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The aim of this cohort study was to assess clinical characteristics that help distinguish between MwA and minor stroke in patients with a previous history of MwA who presented with suspicion of stroke.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We interviewed patients with MwA and ischemic stroke (MwA\u2009+\u2009IS) and patients with MwA and unusual aura, but without ischemic stroke (MwA\u2009\u2212\u2009IS) from a tertiary hospital using a structured questionnaire. We assessed how symptoms of ischemic stroke or unusual aura differed from usual, that is, the typical aura in each patient. Stroke or exclusion of stroke was verified by multimodal magnetic resonance imaging.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Seventeen patients with MwA\u2009+\u2009IS and twelve patients with MwA\u2009\u2212\u2009IS were included. New focal neurological symptoms (13\/17 [76%] vs. 3\/12 [25%]), change of the first symptom (10\/17 [59%] vs. 1\/12 [8%]), and absence of headache (6\/15 [40%] vs. 2\/10 [20%]) were more often reported during ischemic stroke. The physical examination was normal in 8\/17 (47%) MwA\u2009+\u2009IS and in 6\/12 (50%) MwA\u2009\u2212\u2009IS patients. In 5\/17 (29%) patients with MwA\u2009+\u2009IS, there were unequivocal physical signs suggestive of stroke such as persistent visual loss, ataxia, or paresis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>There are clues from the history that might help identify stroke in patients with MwA with changed aura symptoms. These might be particularly useful in patients presenting without physical findings suggestive of stroke.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/head.14682","type":"journal-article","created":{"date-parts":[[2024,2,27]],"date-time":"2024-02-27T23:08:33Z","timestamp":1709075313000},"page":"253-258","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Characteristics of acute ischemic stroke and unusual aura in patients with migraine with aura"],"prefix":"10.1111","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9053-584X","authenticated-orcid":false,"given":"Adrian","family":"Scutelnic","sequence":"first","affiliation":[{"name":"Department of Neurology Inselspital, University Hospital Bern, University of Bern  Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathalie L.","family":"Sutter","sequence":"additional","affiliation":[{"name":"Department of Neurology Inselspital, University Hospital Bern, University of Bern  Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morin","family":"Beyeler","sequence":"additional","affiliation":[{"name":"Department of Neurology Inselspital, University Hospital Bern, University of Bern  Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas R.","family":"Meinel","sequence":"additional","affiliation":[{"name":"Department of Neurology Inselspital, University Hospital Bern, University of Bern  Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9722-9754","authenticated-orcid":false,"given":"Franz","family":"Riederer","sequence":"additional","affiliation":[{"name":"Department of Neurology Inselspital, University Hospital Bern, University of Bern  Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Urs","family":"Fischer","sequence":"additional","affiliation":[{"name":"Department of Neurology Inselspital, University Hospital Bern, University of Bern  Bern Switzerland"},{"name":"Department of Neurology, University Hospital Basel, University of Basel  Basel Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcel","family":"Arnold","sequence":"additional","affiliation":[{"name":"Department of Neurology Inselspital, University Hospital Bern, University of Bern  Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heinrich P.","family":"Mattle","sequence":"additional","affiliation":[{"name":"Department of Neurology Inselspital, University Hospital Bern, University of Bern  Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Jung","sequence":"additional","affiliation":[{"name":"Department of Neurology Inselspital, University Hospital Bern, University of Bern  Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4668-6098","authenticated-orcid":false,"given":"Christoph J.","family":"Schankin","sequence":"additional","affiliation":[{"name":"Department of Neurology Inselspital, University Hospital Bern, University of Bern  Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,2,27]]},"reference":[{"issue":"13","key":"e_1_2_10_2_1","doi-asserted-by":"crossref","DOI":"10.3389\/fneur.2022.1004058","article-title":"Migraine aura\u2010like symptoms at onset of stroke and stroke\u2010like symptoms in migraine with aura","volume":"14","author":"Scutelnic A","year":"2022","journal-title":"Front Neurol"},{"issue":"1","key":"e_1_2_10_3_1","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1093\/brain\/116.1.187","article-title":"Ischaemia\u2010induced (symptomatic) migraine attacks may be more frequent than migraine\u2010induced ischaemic insults","volume":"116","author":"Olesen J","year":"1993","journal-title":"Brain"},{"issue":"10","key":"e_1_2_10_4_1","doi-asserted-by":"crossref","first-page":"979","DOI":"10.1177\/0333102416657147","article-title":"Clinical features of migraine aura: results from a prospective diary\u2010aided study","volume":"37","author":"Viana M","year":"2017","journal-title":"Cephalalgia"},{"issue":"10","key":"e_1_2_10_5_1","doi-asserted-by":"crossref","first-page":"1220","DOI":"10.1111\/j.1468-1331.2011.03364.x","article-title":"Migrainous infarction: a Nordic multicenter study","volume":"18","author":"Laurell K","year":"2011","journal-title":"Eur J Neurol"},{"issue":"22","key":"e_1_2_10_6_1","doi-asserted-by":"crossref","first-page":"1911","DOI":"10.1212\/WNL.0b013e31821d74d5","article-title":"Clinical and MRI characteristics of acute migrainous infarction","volume":"76","author":"Wolf 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ovale after stroke","volume":"326","author":"Kent DM","year":"2021","journal-title":"JAMA"},{"issue":"1","key":"e_1_2_10_13_1","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1038\/jcbfm.2010.191","article-title":"Clinical relevance of cortical spreading depression in neurological disorders: migraine, malignant stroke, subarachnoid and intracranial hemorrhage, and traumatic brain injury","volume":"31","author":"Lauritzen M","year":"2011","journal-title":"J Cereb Blood Flow Metab"},{"issue":"16","key":"e_1_2_10_14_1","doi-asserted-by":"crossref","DOI":"10.3389\/fnhum.2022.1077737","article-title":"Symptoms and patterns of symptom propagation in incipient ischemic stroke and migraine aura","volume":"13","author":"Scutelnic A","year":"2023","journal-title":"Front Hum Neurosci"},{"issue":"3","key":"e_1_2_10_15_1","doi-asserted-by":"crossref","first-page":"852","DOI":"10.1111\/ene.14684","article-title":"Headache at onset of first\u2010ever ischemic stroke: clinical characteristics and predictors","volume":"28","author":"Lebedeva ER","year":"2021","journal-title":"Eur J Neurol"},{"issue":"1","key":"e_1_2_10_16_1","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1186\/s10194-018-0910-y","article-title":"Prolonged migraine aura: new insights from a prospective diary\u2010aided study","volume":"19","author":"Viana M","year":"2018","journal-title":"J Headache Pain"},{"issue":"4","key":"e_1_2_10_17_1","doi-asserted-by":"crossref","first-page":"861","DOI":"10.1007\/s10072-018-3671-0","article-title":"The pathological spectrum behind migraine aura status: a case series","volume":"40","author":"Terrin A","year":"2019","journal-title":"Neurol Sci"},{"issue":"14","key":"e_1_2_10_18_1","doi-asserted-by":"crossref","first-page":"1150","DOI":"10.1177\/0333102414530525","article-title":"Aura status: a not so frequent aura","volume":"34","author":"Jo\u00e3o AA","year":"2014","journal-title":"Cephalalgia"}],"container-title":["Headache: The Journal of Head and Face 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