Headaches preceded by visual aura among adolescents and young adults. A population-based survey
M. S. Linet, D. K. Ziegler and W. F. Stewart
Department of Epidemiology, Johns Hopkins University School of Hygiene and Public Health, Baltimore, Md.
Clinical descriptions of migraine preceded by visual aura often include a
composite of striking and severe symptoms of several attacks in individual
patients, but few studies have characterized the spectrum of such attacks.
In a population-based telephone survey of 8920 Washington County, Maryland,
residents 12 through 29 years old, the attack rate for visual aura
headaches during the week prior to the standardized interview was 3.7% in
male and 6.1% in female subjects. Among female subjects, the risk for
visual aura headache with tension-type symptoms increased with age, whereas
the risk for visual aura headache without tension symptoms decreased with
increasing age. No clear age-related patterns were observed among male
subjects for either type of aura headache. The severity of visual aura
headache with and without tension symptoms increased with age among female
subjects, but showed an inconsistent pattern among male subjects except for
decreasing disability with increasing age. The median interval between the
onset of aura symptoms and the onset of headache (aura interval) was 15
minutes in male subjects and 25 minutes in female subjects, with aura
intervals longer than 60 minutes reported by 12% of male subjects and 20%
of female subjects. In one of the first large population-based studies to
characterize the spectrum of visual aura headache, differing age, gender,
and subtype patterns were found.
