Aura status: A not so frequent aura

Background Migraine aura status is a variety of migraine aura with unvalidated research criteria. Aim and methods We conducted a systematic review of published cases and a retrospective analysis of 500 cases of migraine with aura to evaluate the applicability and clinical features of ICHD-III beta criteria, compared to a more liberal definition for its diagnosis: ≥3 aura episodes for up to three consecutive days. Results Many publications under this title correspond to persistent or formerly designated prolonged auras. Nine cases fulfilled ICHD-III beta status criteria. In our series, either 1.7% or 4.2% cases fulfilled ICDH-III beta or our definition, respectively. Regardless of the criteria, aura status patients were older at onset of status than those with typical aura, had a predominance of visual symptoms, normal neuroimaging and no sequelae. Status recurred in a few. Conclusion Both criteria identify a similar population in terms of age, gender, main symptoms, imaging and outcome. Since patients with closely recurring auras might raise the same approach independently of the criteria, the use of more liberal criteria will allow more cases for detailed diagnosis and therapeutic analysis, eventually leading to the identification of subtypes.

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Clinical features of migraine aura: Results from a prospective diary-aided study

Cephalalgia ◽

10.1177/0333102416657147 ◽

2016 ◽

Vol 37 (10) ◽

pp. 979-989 ◽

Cited By ~ 43

Author(s):

Michele Viana ◽

Grazia Sances ◽

Mattias Linde ◽

Natascia Ghiotto ◽

Elena Guaschino ◽

...

Keyword(s):

Clinical Features ◽

Migraine With Aura ◽

Reliable Data ◽

Visual Features ◽

Clinical Aspects ◽

Migraine Aura ◽

Visual Symptom ◽

Visual Symptoms ◽

Detailed Evaluation ◽

Temporal Succession

Background A detailed evaluation of migraine aura symptoms is crucial for classification issues and pathophysiological discussion. Few studies have focused on the detailed clinical aspects of migraine aura. Methods We conducted a prospective diary-based study of migraine aura features including presence, quality, laterality, duration of each aura symptom, their temporal succession; presence of headache and its temporal succession with aura. Results Seventy-two patients completed the study recording the characteristics of three consecutive auras ( n = 216 auras). Visual symptoms occurred in 212 (98%), sensory symptoms in 77 (36%) and dysphasic symptoms in 22 (10%). Most auras had more than one visual symptom (median 2, IQR 1–3, range 1–4). The majority of patients (56%) did not report a stereotyped aura on the three attacks with respect to visual features, the combination and/or temporal succession of the three aura symptoms. Fifty-seven percent of patients also reported a different scenario of temporal succession between aura and headache in the three attacks. Five per cent of aura symptoms were longer than four hours. Conclusion These findings show a high inter- and intravariability of migraine with aura attacks. Furthermore, they provide reliable data to enrich and clarify the spectrum of the aura phenotype.

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Migraine, migraine aura, and cervical artery dissection: A systematic review and meta-analysis

Cephalalgia ◽

10.1177/0333102411401634 ◽

2011 ◽

Vol 31 (8) ◽

pp. 886-896 ◽

Cited By ~ 65

Author(s):

Pamela M Rist ◽

Hans-Christoph Diener ◽

Tobias Kurth ◽

Markus Schürks

Keyword(s):

Systematic Review ◽

Migraine With Aura ◽

Meta Analysis ◽

Current Evidence ◽

Artery Dissection ◽

Effect Estimate ◽

Cervical Artery Dissection ◽

Migraine Aura ◽

Increased Risk ◽

Cervical Artery

Objective: We evaluated the current evidence on the association between migraine, including aura status, and cervical artery dissection. Methods: We performed a systematic review and meta-analysis of studies investigating the association between migraine or migraine subtypes (e.g. migraine with aura) and cervical artery dissection published through October 2010. Results: We identified five case-control studies investigating the association between migraine and cervical artery dissection. In pooled analysis, migraine doubled the risk of cervical artery dissection (pooled odds ratio [OR] = 2.06, 95% confidence interval [CI] 1.33–3.19). All studies allowed evaluation of migraine aura status. While the effect estimate for migraine without aura (pooled OR = 1.94, 95% CI 1.21–3.10) was similar to overall migraine, the association was weaker for migraine with aura (pooled OR = 1.50, 95% CI 0.76–2.96). However, there is no evidence that aura status significantly modifies the association between migraine and cervical artery dissection (meta-regression on aura status p = .58). The risk does not appear to differ between women and men; however, only few studies presented gender-specific data. Heterogeneity among studies was low to moderate. Conclusion: In this meta-analysis migraine is associated with a two-fold increased risk of cervical artery dissection. This risk does not appear to significantly differ by migraine aura status or gender.

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Clinical features of visual migraine aura: a systematic review

The Journal of Headache and Pain ◽

10.1186/s10194-019-1008-x ◽

2019 ◽

Vol 20 (1) ◽

Cited By ~ 5

Author(s):

Michele Viana ◽

Erling Andreas Tronvik ◽

Thien Phu Do ◽

Chiara Zecca ◽

Anders Hougaard

Keyword(s):

Systematic Review ◽

Clinical Features ◽

Migraine Aura

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Scent of aura? Clinical features of olfactory hallucinations during a migraine attack (OHM)

Cephalalgia ◽

10.1177/0333102416630580 ◽

2016 ◽

Vol 37 (2) ◽

pp. 154-160 ◽

Cited By ~ 4

Author(s):

Federico Mainardi ◽

Alan Rapoport ◽

Giorgio Zanchin ◽

Ferdinando Maggioni

Keyword(s):

Migraine Attack ◽

Clinical Features ◽

Migraine With Aura ◽

Temporal Pattern ◽

Migraine Without Aura ◽

Age At Onset ◽

Average Frequency ◽

Migraine Aura ◽

Phase 2 ◽

Olfactory Hallucination

Introduction Olfactory hallucination during a migraine attack (OHM) is a rare phenomenon. At present, it is not considered a manifestation of migraine aura. Material and methods The clinical features of OHM were collected in 11 patients. Results Of the 11 patients, 10 had migraine without aura and one migraine with aura associated with OHM. Mean age at onset of headache and at appearance of OHM were respectively 17.8 and 32.3 years. Migraine average frequency was 3.9 attacks/month, 19% of them being associated with OHM. The temporal pattern of OHM maintained the same characteristics in the different attacks. OHM onset was described as sudden ( n = 5), gradual ( n = 3), initially sudden and then gradual ( n = 2), or developing in a few seconds ( n = 1). In most of the cases ( n = 8) OHM lasted from 3 to 10 minutes; it persisted during the pain phase (2–24 hours) in only three patients. The type of the perceived smell was invariably constant in nine patients. Conclusion OHM features fulfilled the ICHD-III beta criteria for typical aura.

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Migraine aura symptoms: Duration, succession and temporal relationship to headache

Cephalalgia ◽

10.1177/0333102415593089 ◽

2015 ◽

Vol 36 (5) ◽

pp. 413-421 ◽

Cited By ~ 28

Author(s):

Michele Viana ◽

Mattias Linde ◽

Grazia Sances ◽

Natascia Ghiotto ◽

Elena Guaschino ◽

...

Keyword(s):

Migraine With Aura ◽

Median Duration ◽

Biological Markers ◽

Temporal Relationship ◽

High Variability ◽

Migraine Aura ◽

Temporal Characteristics ◽

Visual Symptoms ◽

Temporal Aspects ◽

Multiple Symptoms

Background As there are no biological markers, a detailed description of symptoms, particularly temporal characteristics, is crucial when diagnosing migraine aura. Hitherto these temporal aspects have not been studied in detail. Methods We conducted a prospective diary-aided study of the duration and the succession of aura symptoms and their temporal relationship with headache. Results Fifty-four patients completed the study recording in a diary the characteristics of three consecutive auras ( n = 162 auras). The median duration of visual, sensory and dysphasic symptoms were 30, 20 and 20 minutes, respectively. Visual symptoms lasted for more than one hour in 14% of auras ( n = 158), sensory symptoms in 21% of auras ( n = 52), and dysphasic symptoms in 17% of auras ( n = 18). Twenty-six percent of patients had at least one aura out of three with one symptom lasting for more than one hour. In aura with multiple symptoms the subsequent symptom, second versus first one or third versus second, might either start simultaneously (34 and 18%), during (37 and 55%), with the end (5 and 9%), or after (24 and 18%) the previous aura symptom. The headache phase started before the aura (9%), simultaneously with the onset of aura (14%), during the aura (26%), simultaneously with the end of aura (15%) or after the end of aura (36%). Conclusion We provide data to suggest that symptoms may last longer than one hour in a relevant proportion of auras or migraine with aura patients, and that there is a high variability of scenarios in terms of time relationship among aura symptoms and between aura and headache.

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Clinical Features And Outcomes Of Patients With Small Cell Lung Carcinoma; Retrospective Analysis

Acta Medica Anatolia ◽

10.15824/actamedica.65675 ◽

2015 ◽

Vol 3 (2) ◽

pp. 47 ◽

Cited By ~ 1

Author(s):

Duygu Unalmış ◽

Zehra Yasar ◽

Melih Buyuksirin ◽

Gulru Polat ◽

Fatma Demirci Ucsular ◽

...

Keyword(s):

Retrospective Analysis ◽

Clinical Features ◽

Lung Carcinoma ◽

Small Cell Lung Carcinoma ◽

Small Cell ◽

Small Cell Lung ◽

Cell Lung Carcinoma

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Clinical features and outcomes of pregnant women with COVID-19: a systematic review and meta-analysis

BMC Infectious Diseases ◽

10.1186/s12879-020-05274-2 ◽

2020 ◽

Vol 20 (1) ◽

Cited By ~ 9

Author(s):

Yi-jie Gao ◽

Lei Ye ◽

Jia-shuo Zhang ◽

Yang-xue Yin ◽

Min Liu ◽

...

Keyword(s):

Systematic Review ◽

Pregnant Women ◽

Clinical Features ◽

Meta Analysis

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Clinical features and outcomes of COVID-19 in older adults: a systematic review and meta-analysis

BMC Geriatrics ◽

10.1186/s12877-021-02261-3 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Sunny Singhal ◽

Pramod Kumar ◽

Sumitabh Singh ◽

Srishti Saha ◽

Aparajit Ballav Dey

Keyword(s):

Systematic Review ◽

Older Adults ◽

Critically Ill ◽

Clinical Features ◽

Older Patients ◽

Clinical Characteristics ◽

Meta Analysis ◽

Severe Infection ◽

Factors Affecting ◽

Pooled Prevalence

Abstract Background Few studies have focused on exploring the clinical characteristics and outcomes of COVID-19 in older patients. We conducted this systematic review and meta-analysis to have a better understanding of the clinical characteristics of older COVID-19 patients. Methods A systematic search of PubMed and Scopus was performed from December 2019 to May 3rd, 2020. Observational studies including older adults (age ≥ 60 years) with COVID-19 infection and reporting clinical characteristics or outcome were included. Primary outcome was assessing weighted pooled prevalence (WPP) of severity and outcomes. Secondary outcomes were clinical features including comorbidities and need of respiratory support. Result Forty-six studies with 13,624 older patients were included. Severe infection was seen in 51% (95% CI– 36-65%, I2–95%) patients while 22% (95% CI– 16-28%, I2–88%) were critically ill. Overall, 11% (95% CI– 5-21%, I2–98%) patients died. The common comorbidities were hypertension (48, 95% CI– 36-60% I2–92%), diabetes mellitus (22, 95% CI– 13-32%, I2–86%) and cardiovascular disease (19, 95% CI – 11-28%, I2–85%). Common symptoms were fever (83, 95% CI– 66-97%, I2–91%), cough (60, 95% CI– 50-70%, I2–71%) and dyspnoea (42, 95% CI– 19-67%, I2–94%). Overall, 84% (95% CI– 60-100%, I2–81%) required oxygen support and 21% (95% CI– 0-49%, I2–91%) required mechanical ventilation. Majority of studies had medium to high risk of bias and overall quality of evidence was low for all outcomes. Conclusion Approximately half of older patients with COVID-19 have severe infection, one in five are critically ill and one in ten die. More high-quality evidence is needed to study outcomes in this vulnerable patient population and factors affecting these outcomes.

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Risk Factors, and Clinical and Etiological Characteristics of Ischemic Strokes in COVID-19-Infected Patients: A Systematic Review of Literature

Cerebrovascular Diseases ◽

10.1159/000514267 ◽

2021 ◽

pp. 1-4

Author(s):

Simone Vidale

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Clinical Features ◽

Case Reports ◽

Clinical Severity ◽

Large Artery ◽

Causal Association ◽

Review Of Literature ◽

Increased Risk ◽

Long Time

Background and Purpose: Coronavirus disease 2019 (COVID-19) infection is an ongoing pandemic and worldwide health emergency that has caused important changes in healthcare systems. Previous studies reported an increased risk of thromboembolic events, including stroke. This systematic review aims to describe the clinical features and etiological characteristics of ischemic stroke patients with COVID-19 infection. Method: A literature search was performed in principal databases for studies and case reports containing data concerning risk factors, clinical features, and etiological characteristics of patients infected with COVID-19 and suffering from stroke. Descriptive and analytical statistics were applied. Results: Overall, 14 articles were included for a total of 93 patients. Median age was 65 (IQR: 55–75) years with prevalence in males. Stroke occurred after a median of 6 days from COVID-19 infection diagnosis. Median National of Institute of Health Stroke Scale (NIHSS) score was 19. Cryptogenic (Cry) strokes were more frequent (51.8%), followed by cardioembolic etiology, and they occurred a long time after COVID-19 diagnosis compared with large-artery atherosclerosis strokes (ptrend: 0.03). The clinical severity of stroke was significantly associated with the severity grade of COVID-19 infection (ptrend: 0.03). Conclusions: Ischemic strokes in COVID-19-infected patients were clinically severe, affecting younger patients mainly with Cry and cardioembolic etiologies. Further multicenter prospective registries are needed to better describe the causal association and the effect of COVID-19 infection on stroke.

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