Scutelnic, Adrian; Petroulia, Valentina; Schraml, Lara; Jung, Simon; Branca, Mattia; Beyeler, Morin; Fischer, Urs; Wiest, Roland; Slavova, Nedelina; Schankin, Christoph J (2023). The "index vein" as a sign for migraine aura in the emergency setting. Cephalalgia : an international journal of headache, 43(1), p. 3331024221132010. International Headache Society 10.1177/03331024221132010
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Background and objectives To assess the usefulness of the "index vein" for making the diagnosis of migraine aura.Methods 400 patients were included when they: i) presented with an acute neurological deficit, ii) had a brain MRI, and iii) had a discharge diagnosis of migraine aura, ischemic stroke, epileptic seizure or controls (n = 100 per group).Results Compared to stroke (2%), epileptic seizure (4%) and controls (1%), the index vein is more prevalent in migraine aura (17%, p < 0.001). The index vein is highly specific for migraine aura (specificity 97%, 95% CI 95-99). The index vein has a positive predictive value for the diagnosis of migraine aura of 70% (95%CI 48-87). The index vein-score has the ability to diagnose migraine aura with a sensitivity of 94% (95%CI 87.4-97.8) and specificity of 73.5% (95%CI 66.8-79.5) at a cut-off of 4 points.Discussion The index vein serves as a good biomarker for migraine aura in the emergency setting.
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