Migraine aura or transient ischemic attacks? A five-year follow-up case-control study of women with transient central nervous system disorders in pregnancy

<p>Abstract</p> <p>Background</p> <p>Migraine aura may be difficult to differentiate from transient ischemic attacks and other transient neurological disorders in pregnant women. The aims of the present study were to investigate and diagnose all pregnant women with transient neurological disorders of suspected central nervous system origin, and to compare this group with a control group of pregnant women with regard to vascular risk factors and prognosis.</p> <p>Methods</p> <p>During a 28 month period, 41 patients were detected with transient neurological symptoms during pregnancy. These were studied in detail with thorough clinical and laboratory investigations in order to make a certain diagnosis and to evaluate whether the episodes might be of a vascular nature. For comparison, the same investigations were performed in 41 pregnant controls. To assess the prognosis, both patients and controls were followed with questionnaires every year for five years.</p> <p>Results</p> <p>Migraine with aura was the most common cause of symptoms during pregnancy, occurring in 34 patients, while 2 were diagnosed with stroke, 2 with carpal tunnel syndrome, 1 with partial epilepsy, 1 with multiple sclerosis and 1 with presyncope. Patients had more headache before pregnancy than controls, but the average levels of vascular risk factors were similar. None of the patients or the controls reported cerebrovascular episodes during the five-year follow-up.</p> <p>Conclusion</p> <p>The diagnosis of migraine aura was difficult because for many patients it was their first ever attack and headache tended to be absent or of non-migraineous type. The aura features were more complex, with several aura symptoms and a higher prevalence of sensory and dysphasic aura than usual. Gradually developing aura symptoms, or different aura symptoms occurring in succession as described in the International Classification of Headache Disorders, seem to be useful for differentiating aura from other transient disorders. A meticulous history and clinical neurological examination are more useful than routine supplementary investigations for cerebrovascular disease. The five-year follow-up clearly indicates that migraine with aura in pregnancy usually has a good prognosis with regard to cerebrovascular events.</p

An improved north–south synchronization of ice core records around the 41 kyr 10^{10}Be peak

International audienceUsing new high-resolution 10Be measurements in the NGRIP, EDML and Vostok ice cores, together with previously published data from EDC, we present an improved synchronization between Greenland and Antarctic ice cores during the Laschamp geomagnetic excursion  ∼  41 kyr ago. We estimate the precision of this synchronization to be ±20 years, an order of magnitude better than previous work. We discuss the implications of this new synchronization for making improved estimates of the depth difference between ice and enclosed gas of the same age (Δdepth), difference between age of ice and enclosed gas at the same depth (Δage) in the EDC and EDML ice cores, spectral properties of the 10Be profiles and phasing between Dansgaard–Oeschger-10 (in NGRIP) and AIM-10 (in EDML and EDC)