In case of failure of NSAIDs or aspirin it is recommended to use a triptan when the headache begins. It is recommended to start non-steroidal anti-inflammatory drugs (NSAIDs) or aspirin as soon as possible during the aura phase, not to treat the aura, but to avoid or to diminish the headache phase. Combined hormonal contraception with estrogens significantly increases the risk of stroke in women with migraine with aura. The relative risk of ischemic stroke is significantly increased in migraine with aura. Long duration (greater than one hour) of what may or may not be an aura phase, late onset of aura, or a dramatic increase in aura attacks should also be explored. If the patient has no visual aura symptoms or simultaneous neurological symptoms, or presents neurological symptoms corresponding to a cerebral vascular territory, emergency exploration of a possible transient ischemic attack is necessary. When a patient experiences for the first time a possible aura phase it's sometimes difficult to know if there was gradual or brutal onset of the symptoms. The accepted duration for most aura symptoms is one hour, but motor symptoms, which are rare, are often longer lasting. When aura symptoms are multiple, they usually follow one another in succession, beginning with visual, then sensory, then aphasic but the reverse and other orders have been noted. Visual aura is the most common type of aura, occurring in over 90% of patients. Aura is characterized by gradual development, duration of each symptom no longer than one hour, a mix of positive and negative features, and complete reversibility. The diagnosis is based on the International Headache Classification Disorders III edition criteria. The pivotal role of cortical spreading depression (CSD) as a mechanism underlying aura has been widely supported by a large body of studies. Aura is a fully reversible focal neurological phenomenon involving visual, sensory, speech, and/or motor symptoms that develops gradually and usually precedes the headache phase. It was concluded that male sex hormones and especially testosterone do not play an important role in the exacerbation of migraine headache.Around 15% to one-third of migraineurs experience aura. Conclusion: Migraine is not more frequent in women with PCO. The same results were found for migraine headache (p = 0.13). The prevalence of headache was not significantly higher among women with PCO (p = 0.85). Of the PCO patients, 48 women (44.9%) suffered from headache. Results: Forty-five women (33.8%) of the 133 cases without PCO complained of headache. The statistical significance was determined using the χ 2 test, and a p value of <0.05 was considered significant. The headache disorders were classified according to the International Headache Society criteria. Methods: One hundred and thirty-three women with PCO and 107 controls were interviewed by 2 neurologists experienced in headache diagnosis. Background: To evaluate the role of some sex hormones in migraine headaches, the aim of this study was to assess the prevalence and characteristics of headache, especially migraine, in patients with polycystic ovary syndrome (PCO) compared with women without this disease.
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