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Are Migraines Related To Strokes

Managing Risk Of Stroke In Migraine

Migraine and stroke

As a risk factor you cant help having migraine with aura. However, there are some things that can help to manage other risk factors for stroke. Managing any vascular risk factors such as high blood pressure and high cholesterol can help. As can managing any other conditions that may increase your risk, such as arterial hypertension or Diabetes.

There are certain risk factors for stroke that can affect anyone at any age. These include:

  • smoking
  • high blood pressure
  • being overweight

These are likely to have more of an impact on your risk of stroke than migraine. If youre worried about your risk of stroke you should speak to your GP about your individual risk of stroke.

The Relationship Between Headache And Stroke

About 18% of stroke patients experience a headache during the onset of the stroke. Therefore, headaches should be taken seriously and treated with emergency medical attention.

Ocular migraines are particularly known to be associated with a higher risk of stroke. Pay attention to visual disturbances if you are concerned that a headache is related to a stroke.

Unfortunately, strokes without the hallmark symptoms are often misdiagnosed. You can help save a life by spreading awareness and insisting on an MRI scan if you believe something is wrong.

Migraine And Ischemic Stroke: Association

An association between migraine and ischemic stroke has been observed for many years, although the exact mechanisms by which migraine can lead to stroke are currently still under investigation.9 Migraine is associated with an increased stroke risk and is considered an independent risk factor for ischemic stroke in a particular subgroup of patients; it is related to stroke in several ways9,10:

Ischemic stroke can develop as a complication of an attack of MA .

Epidemiological studies suggest that MA is a risk factor for ischemic stroke.

A patent foramen ovale is a well-known risk factor for stroke and seems to be associated with MA.9

Ocular Migraines And Stroke

Henry HoffmanThursday, September 27th, 2018

Today, migraines are considered the most common neurological disorder according to the Journal of Stroke, and, in the United States alone, about people suffer from these debilitating headaches. Research has determined that all migraineurs are at a higher risk of suffering a stroke, and this risk factor is potentiallydoubled or tripled for individuals who suffer from migraines with visual disturbances collectively known as aura.

Unfortunately, migraines with aura exhibit similar symptoms to those associated with certain life-threatening conditions, namelytransient ischemic attacks and strokes. For this reason, many migraineurs may mistake early stroke warning signs for classic migraine symptoms. Telling the difference and recognizing a medical emergency for what it is can be difficult, but isnt impossible.

What Is Ocular Migraine

Cerebral Aneurysm

According to the American Migraine Foundation, about 25 to 30 percent of people with migraine experience aura, and less than 20 percent have it with every attack.

Migraine with aura involves visual distortions that might remind you of looking through a kaleidoscope. It typically affects both eyes. Symptoms can include:

  • sparkling or shimmering spots
  • speech changes

Certain things, like bright or flashing light, can trigger migraine with aura.

An attack usually starts with a small spot that slowly expands. It might dart away when you try to focus on it. You may still see it when you close your eyes.

These can be disturbing, but theyre temporary and not usually harmful.

The attack typically lasts 20 to 30 minutes, after which vision returns to normal.

For some people, this aura is a warning sign that migraine pain and other symptoms will soon hit. Others have aura and pain at the same time.

An attack can also happen by itself, with no pain. This is called acephalgic migraine or silent migraine.

Migraine with aura isnt the same as retinal migraine, which is more serious. Retinal migraine happens in only one eye and can cause temporary blindness or in some cases, irreversible damage.

Having migraine with aura doesnt mean youre having a stroke or that stroke is about to happen. If you have migraine with aura, though, you may be at a higher risk of stroke.

Patient Characteristics As Risk Factors For Headache After Stroke

To determine the effect of stroke location and sex on ischemic stroke headache, data from studies that reported headache prevalence in these subgroups were used to calculate a crude odds ratio using 2 × 2 tables for each study and combined using a fixed effects heterogeneity model to generate a pooled estimate.

Cerebrovascular Events Triggering A Migraine

The association between migraine and stroke is complicated by the fact that almost any cerebrovascular event can trigger a migraine-like attack , which may lead to misinterpretation of the stroke event as complicated migraine. The increased frequency of migraine aura in later life may be the symptomatic expression of an underlying stroke risk factor rather than the aura itself increasing the risk of stroke. Most studies, particularly prospective studies, collect information on migraine status before the vascular event, and thus is not the mechanism behind the migraine-stroke association.

Statistics For Ocular Migraines And Stroke Risk

If you were suspicious that migraines and stroke were connected, you were right.

Migraine sufferers are at a higher risk of ischemic stroke, which is the type of stroke caused by a blood clot obstructing an artery in the brain.

The risk of stroke almost triples for those who suffer from regular ocular migraines, according to the American Stroke Association.

Of course, that does not mean that every person who experiences an ocular migraine will suffer a stroke, only that their risk is higher than the average population.

But what exactly is an ocular migraine anyway?

Stroke Or Migraine The Migraine

Does migraine cause stroke? | Norton Neuroscience Institute

Migraine is the most common neurological disorder, affecting 10% to 15% of adults in the U.S. According to a study published in the Journal of Stroke, people who suffer from migraine headaches have increased risks for a variety of vascular diseases, including ischemic stroke and hemorrhagic stroke.

TheNational Headache Foundation reported that people who have migraine with aura are more than twice as likely to have an ischemic stroke as people who have migraine without aura. In addition to a severe headache, it is these aura symptoms that can mimic some of the signs of a stroke or transient ischemic stroke .

Migraine And Risk Of Perioperative Stroke

Perioperative stroke, defined as stroke occurring within 30 days of surgery, is a highly relevant surgical complication, associated with increased mortality rates and serious long-term morbidities. Patients with migraine receiving surgery under general anaesthesia are found to have a higher 30day risk of ischaemic stroke than those without migraine , suggesting that migraine should be included in the risk assessment for perioperative ischaemic strokes. The association between migraine and perioperative stroke was strongest in patients with MA and in those without cardiovascular risk factors. Surgical patients with migraine are also more likely to be readmitted to the hospital, most of these readmissions appear to be related to pain.

Clinical implication

Physicians should know of the increased risk of perioperative ischaemic stroke in patients with migraine, and include migraine in the preoperative risk assessment.

Migraine And Vascular Risk Factors

The role of conventional vascular risk factors on the risk of cardiovascular events in people with migraine is controversial. Migraine, and particularly MA, is associated with an unfavourable cardiovascular risk profile and an increased 10-year predicted risk of coronary heart disease based on the Framingham Risk Score. Frequent headache and long-term migraine are associated with a poorer cardiovascular risk profile. Although people with migraine have an increased risk of ischaemic stroke in the presence of vascular risk factors, several studies have shown that the association between migraine and ischaemic stroke is apparent in people with low Framingham Risk Score. The few exceptions were a positive association with family history of cardiovascular disease, cigarette smoking and oral contraceptives. This agrees with reports that coronary and carotid arteries of individuals with active migraine are found to be less severely affected by atherosclerosis than individuals without migraine, suggesting a non-atherosclerotic mechanism behind the MA-ischaemic stroke link.

Clinical implication

Migraine Stroke And Special Concerns In Women

Migraine is a predominantly female disorder, affecting women with a ratio of approximately 3:1 to men. The highest 1-year prevalence of migraine is between ages of 25 and 55 years, and it is estimated that 22%37% of women will experience migraine during their reproductive years. As the association between migraine and ischaemic stroke is particularly strong in women with MA under the age of 45, certain aspects during a womans life need to be considered.

Which Migraine Types Can Resemble Stroke

Finding Out the Difference of Migraine & Stroke

Migraine with aura is the type of migraine most commonly mistaken for stroke. The aura in migraine with aura is a set of visual, sensory, or other nervous system symptoms that usually last between a few minutes and an hour, and usually precede the headache phase of an attack. Its possible to have aura symptoms with no headache.

About 25 percent of people with migraine experience auras, according to the Migraine Research Foundation.

The most common aura symptoms are visual effects such as bright flashing lights or spots or zigzags in a persons field of vision. Other possible aura symptoms include losing sight for short periods; having tingling and numbness in the face, hands, or other areas of the body; hearing sounds such as buzzing or music; and having speech and language problems such as being unable to say words, slurring, or mumbling, according to the American Migraine Foundation. Any of those could easily be assumed to be signs of a stroke.

Another migraine type that can cause stroke-like symptoms is a very rare inherited condition called familial hemiplegic migraine, or sporadic hemiplegic migraine if it occurs in only one person in a family. Symptoms of a hemiplegic migraine attack are the same as migraine with aura but also include motor, or muscle, weakness on one side of the body that may persist for days or even weeks. Rarely, hemiplegic migraine can cause fever, confusion, loss of consciousness, or even profound coma.

Cerebral Autosomal Dominant Arteriopathy With Subcortical Infarcts And Leukoencephalopathy

Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy is an autosomal dominant disease caused by rare mutations of the gene encoding the neurogenic locus notch homolog protein 3 located on chromosome 19p13 . The gene encodes a vascular smooth muscle cells receptor. Its defect leads to chronic white matter ischemia due to non-artheriosclerotic, non-amyloid vasculopathy with fibrosis and an accumulation of granular and osmiophilic substances perforating cerebral arteries . Stroke risk among these patients is enhanced. It should be suspected when a patient has one or more of recurrent subcortical ischemic strokes at the mean age of 45 years, especially in the absence of other risk factors, migraine and/or early cognitive decline, or subcortical dementia usually associated with pseudobulbar palsy . Migraine, typically with aura, occurs in about 30% of patients. It is usually the earliest symptom, and in some patients the only clinical manifestation of the disease . In most cases attacks of migraine improve or cease when other manifestations of CADASIL appear . Magnetic resonance imaging is always abnormal with well delineated, small, bilateral infarcts typically seen in the deep white matter and in the periventricular region predominantly in the frontal, parietal and anterior temporal lobes, rarely in the occipital lobes .

Is It A Migraine Or Another Type Of Headache

Although many people describe all moderate to severe headaches as “migraine,” there are specific criteria used to identify migraine, tension, and other less-common headache varieties.

One of the differences between headache and migraine pain is that migraine pain has a throbbing quality, and even the slight physical exertion may worsen their pain.

Stroke Or Migraine How To Know The Difference

Youre hit suddenly with a blinding headache. Maybe youve had migraines before and this feels like another one. Or maybe youve never had a migraine but imagine this is what one must feel like. You might be right, but what if youre not? Just like stomach pain and chest pain, a bad headache can indicate a number of conditions that have similar or overlapping symptoms. Since both stroke and migraine are common neurovascular disorders with many neurological and physical similarities, your throbbing head could be a migraine mimicking a stroke or a stroke disguised as a migraine. So which it is: stroke or migraine? Knowing the difference could save your life.

Can Migraine And Stroke Happen At The Same Time

Migraine and Stroke: Q&A with Dr. Gretchen Tietjen

You may be worried your migraine attack is a symptom of a stroke. Or that you are more at risk of a stroke during a migraine attack. In some people migraine and an ischaemic stroke occur together, but its not clear why this is. When this happens, it is known as migrainous infarction. It is considered rare, and is usually diagnosed by ruling out everything else.

Migrainous infarction features prolonged aura symptoms , aura symptoms that are typical for you and a brain scan showing signs of damage, with no other cause.

It is possible to have a headache during a stroke which is similar to migraine. It is also possible for people to have a stroke which is mistaken for a migraine attack. Migraine aura symptoms can be similar to the symptoms of TIAs.

Migraines Can Be Managed With Proper Care And Treatment

In the United States alone, strokes account for nearly140,000 deaths every single year. If you or a loved one are experiencing a stroke, seek immediate medical attention to prevent long-term damage and disability. According to the CDC, Patients who arrive at the emergency room within 3 hours of their first symptoms often have less disability 3 months after a stroke than those who received delayed care.

Understanding your migraines and your specific migraine triggers may help you avoid or at least minimize the occurrence of these disorienting episodes. However, even with the most  robust prevention, migraines will still occur for many sufferers. With the inherent elevated stroke risk associated with all migraines , its crucial to know how to recognize the symptomatic discrepancies between the two, and act fast if faced with a potential stroke.

If you or a loved one has experienced a stroke, you know that it can have a significant impact on ones life. Here at Saebo, we are committed to stroke support and recovery to improve the overall quality of life for all survivors and their families.Saebo offers a wide range of products that combine cutting-edge technology with evidence-based rehabilitation techniques. Our offerings and network of Saebo-trained therapists can help you or a loved one to obtain all the necessary tools to maximize stroke recovery.

Changes To Your Vision Will Be Different Depending On What Youre Experiencing

In migraines, vision problems are one noticeable aura symptom, according to the University of Michigan. You may see a geometric or zigzag pattern in your visual field or flashing lights, according to Dr. Dougherty. But vision changes are notably different during a stroke. Rather than noticing shapes, your environment will suddenly appear dark or blurry, according to Phil Stieg, Ph.D., M.D., a neurosurgeon and founder of the Weill Cornell Medicine Brain and Spine Center. One of the telltale signs of stroke is if a persons eyes feel like the blinds are being pulled down, Dr. Stieg tells SELF.

Mechanisms Underlying The Migraine Sd And Stroke Association

Consistent with the accelerated infarct growth in migraine mutant mice, acute stroke patients with a history of migraine also show rapid infarct expansion. There is only a small amount of potentially salvageable brain tissue/mismatch in migraineurs, when penumbra is determined by cerebral blood volume / mean transit time mismatch on CT perfusion , or diffusion weighted imaging / MTT mismatch on MR perfusion . Additionally, the amount of penumbra that could be salvaged was smaller among MA patients in comparison to MO and non-migraineous cases, highlighting increased brain tissue vulnerability in migraineurs . Preclinical data support a key role for SD susceptibility in mediating stroke risk in migraineurs. In fact, as outlined below in more detail, there is evidence in migraine-susceptible brains for an increased incidence of 1) SD triggering factors such as microemboli, 2) a reduced threshold for SD induction, 3) an increased frequency of ischemia-triggered SD, and 4) worse consequences of individual SDs on the metabolic mismatch. However, considering that migraineurs also have an increased risk of myocardial infarction, venous thromboembolism and atrial fibrillation, a systemic dysfunction not limited to the cerebral vasculature could also contribute to the increased stroke risk in migraineurs .

Migraine And Risk Of Cardiovascular Disease

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There is growing evidence of an association between migraine and other cardiovascular disorders including myocardial infarction, hypertension, venous thromboembolism and atrial fibrillation , with stronger association in people with MA. An association between migraine and cardiovascular disease mortality has also been found. While the annual cardiovascular mortality risk for migraine is relatively low, the risk may accumulate when magnified across decades of individual migraine exposure. The QRISK3 algorithm was recently developed and validated to predict 10-year risk of cardiovascular disease in men and women aged 2584 years. Migraine being included in this algorithm indicates its importance in the risk prediction of cardiovascular disease. Although evidence for a link between migraine and cardiovascular disease exist, it is still unclear whether migraine itself increases the risk or is a marker of another underlying cause. Improvement of aura with aspirin and migraine with warfarin has been observed in observational case studies; however, further research is necessary to confirm these effects. There is no evidence that controlling migraine attacks with preventive drugs can reduce cardiovascular risk.

Clinical implication

Current migraine guidelines do not recommend use of antithrombotic drugs in the prophylaxis of migraine, but clinicians should consider whether patients at particularly high risk of cardiovascular disease would benefit from such treatment.

What Symptoms Must You Have To Be Diagnosed With A Migraine

Migraine with aura . This is a headache, plus:

  • Visual symptoms or vision loss.
  • Sensory symptoms .

Migraine without aura . A common migraine is a headache and:

  • The attacks included pain on one side of your head.
  • Youve had at least five attacks, each lasting between four and 72 hours.

Plus, youve experienced at least one of the following:

  • Nausea and/or vomiting.
  • Lights bother you and/or you avoid light.
  • Sounds bother you and/or you avoid sounds.

Understand Your Symptoms And Whether Your Migraine May Carry An Additional Stroke Risk

Migraine attacks accompanied by aura are associated with stroke and heart disease, and women might be particularly at risk for migraine-related stroke, said Dr. Gretchen Tietjen, the chair of the University of Toledos Department of Neurology. But Tietjen, a neurologist who specializes in stroke and headache medicine, says that lifestyle choices, like sleeping well and using preventive medication, may help mitigate that additional risk.

Are Migraines Hereditary

Migraines tend to run in families. As many as four out of five people with migraines have a family history. If one parent has a history of migraines, their child has a 50% chance of having them. If both parents have a history of migraines, the risk jumps to 75%. Again, up to 80% of people with migraines have a first-degree relative with the disease.

What Is Migraine

Post Stroke Headache

A migraine attack can have a wide range of symptoms. For many people the key symptom is a moderate or severe headache. Usually this is felt as a throbbing pain on one side of your head. This is often accompanied by other symptoms such as nausea and vomiting, and sensitivity to light or sound.

Migraine affects around one in every 15 men, and one in five women. People of all ages are affected by migraine, but the condition often begins in young adulthood. It often runs in families, and many people with migraine have a close relative with the condition. Some people have several migraines a week; others may have years between migraine attacks. Symptoms can last from a few hours to several days, and you may also feel very tired for up to a week after an attack.  Migraine without aura 

Between 70% and 90% of the population with migraine have this type, which is sometimes called common migraine. It consists of a headache with other symptoms such as nausea and sensitivity to light, sound or smell. The other symptoms usually begin at the same time as the headache, and disappear once the headache goes. Many people feel irritable and need to rest in a dark room or sleep afterwards.   

Migraine with aura 

Types of aura

Migraine aura without headache

Also known as a silent migraine, this is an aura without the headache.  

Rare types of migraine

There are some rare types of migraine, which are also classed as migraine with aura. 

Migraine with brainstem aura

Hemiplegic migraine

What Is A Stroke

Stroke is a serious medical condition. It happens when the blood supply to part of the brain is cut off and brain cells die. There are two main causes of stroke:

  • ischaemic caused by the blood supply being stopped due to a blood clot, its responsible for most cases of stroke.
  • haemorrhagic where weakened blood vessels that supply the brain burst.

There is also another condition known as a transient ischaemic attack . This is where the blood supply to the brain is temporarily interrupted. It may also be called a mini-stroke and can last a few minutes or go on for up to 24 hours. Some types of migraine attack may be mistaken for a TIA .

Stroke During A Migraine

In rare instances, a stroke can occur during a migraine attack, usually in young women who have a history of migraine with aura. This is called a migrainous infarction, and it’s so uncommon that the vast majority of people who have migraines will never experience this rare complication. Scientists are still trying to understand why this happens and what the cause-effect relationship is.

Some stroke survivors begin to experience headaches after having a stroke. Generally, though, these headaches aren’t described as migraines and they’re not normally associated with neurological symptoms.

How Kaylas Headache Was Eventually Linked To Her Stroke

While headaches are not a common side effect of stroke, it should still be considered a warning sign.

A young woman named Kayla experienced her stroke at the age of 21. Her first symptoms involved a knife of a headache. However, because doctors are not trained to associate headaches with stroke, she was misdiagnosed.

When Kayla went to the emergency room the next morning, she was diagnosed with a migraine and no tests were taken. Over the next 2 days, her symptoms worsened.

At that point, her doctor ordered an MRI and the stroke was finally identified. Over those two days, sections of Kaylas brain werent receiving enough oxygen-rich blood, and her risk of disability and even death was not managed.

It took Kayla several years to recover, but fortunately she has recovered almost completely, aside from experiencing seizures which she takes medication for.

We hope Kaylas story, which you can find in Stroke Connection magazine, shows the importance of taking headaches seriously.

Articles On Migraine Complications

Status Migrainosus and Stroke

If migraines are a regular part of your life, you might want to pay extra attention to your heart health, too. Studies show that some folks who get migraines are also more likely to have strokes and heart attacks.

If you have only occasional migraines, this may not be something you need to worry about. But if it’s a regular, long-term problem for you — especially if you get visual symptoms with your migraine — your chances of heart disease could go up.

Doctors aren’t clear why there’s a link between migraines and heart trouble. Some experts think that during a migraine with a visual aura, blood flow to one small area of the brain declines for a while, which can lead to inflammation in blood vessels.

Other doctors think the same genes that make people likely to get migraines also raise their chances of heart disease.

Either way, it’s important to know about the risk and watch for early warning signs of heart trouble or stroke.


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