Many standard migraine preventive drugs also appear effective in reducing aura, such as topiramate and certain antidepressants. Some medications that probably effectively prevent aura may not work as well in prevention of migraine without aura, such as lamotrigine

and verapamil. A different class of medications, not commonly used for migraine prevention alone, has shown promise in the prevention of aura. Memantine blocks the N-methyl-D-aspartate (NMDA) glutamate receptor in the brain and is believed to inhibit the spread of brain signaling that occurs with aura. Magnesium may also work by plugging the NMDA glutamate receptor. The risk of stroke in women with migraine without aura is likely not increased beyond that of non-migraineurs. The risk is estimated to increase up to twice normal if a woman does have aura, but this risk

remains very low overall. Adding in estrogen-containing contraception raises the stroke risk 6-fold, and in migraineurs with aura who smoke and use estrogen containing contraceptives, the risk of stroke becomes considerable at 9 times the expected level. Use of selleckchem progesterone-only contraceptives is not clearly linked to stroke. It is strongly recommended that those who have migraine with aura as well as tobacco dependence, at any age, cease smoking. In women with aura older than age 35, particular caution is advised in using estrogen-containing contraceptives or taking hormone replacement therapy because of this additional risk. When discussing contraceptive Tau-protein kinase options, women should notify their gynecologist or primary care doctor if they have migraine with aura. Anyone whose aura worsens after using hormonal therapy will need to stop it. If aura is

atypical, for instance if individual visual, sensory, or speech symptoms last longer than an hour, or there is accompanying weakness, hormonal contraception containing estrogen should not be used. Aura is a common accompaniment to migraine, occurring in about one-quarter of those with migraine. It usually follows an established pattern in any given migraineur. When recognized as typical, it can be treatable and even serve as an early warning to begin addressing the migraine before significant pain onset. With reasonable precautions, such as avoidance of smoking and judicious consideration of estrogen contraception, migraine with aura is a treatable problem seldom associated with complications. To find more resources, please visit the American Migraine Foundation (http://kaywa.me/ir2eb) “
“(Headache 2010;50:146-148) Acquired cerebellar tonsillar herniation is a known complication of lumboperitoneal shunt (LPS) for any indication, including idiopathic intracranial hypertension (IIH), also known as pseudotumor cerebri.1 While the underlying pathophysiology of IIH remains unknown, increasing body mass index is a clear risk factor for the development of IIH.