Migraines, a Stroke Story

If you have been reading my blogs about migraines, you should already understand that migraines are a complicated neurological process that involves multiple systems in the body. Migraines are not just headaches, there can be significant comorbidities or associated problems. Today we are going to talk about the relationship between Migraines and Stoke.

We have known that there is a clear relationship between Migraines with aura and Stroke. Migraine with Aura can be an independent risk factor for stroke. Smoking and oral contraception can even more significantly increase the risk of stroke in patients. There is even a disorder called Migranous infarction. This is when a severe attack of migraine with aura has a persistent aura and headache that leads to stroke. Diagnostic testing such as an MRI can reveal a stroke in the brain that was responsible for the symptoms the patient was experiencing. For example, a patient can experience a visual aura and headache and develop sever symptoms consistent with stroke. This same patient can be later found to have had a stroke in the visual area of the brain such as the occipital lobe. These sever Migranous infarctions can be found in young people who are not at risk for stoke. In patients who have not had obvious stroke like symptoms, there has been evidence of clinically silent strokes on imaging studies. These clinically silenced strokes are seen with increased frequency in patients with migraines.

There is also the opposite effect. New headache with migraine features can be seen after a stroke. We see this most often in patients that have strokes in the back part or posterior of the brain. Patients can present with new onset headache at the time of the stroke and for some it can be an ongoing issue after the episode of stroke. It is therefore important that if a patient has a headache more intense or severe than a usual headache, they seek medical attention as there may be a more serious underlying issue. Patients with migraines should introduce healthy lifestyle habits like avoiding smoking, blood pressure control, appropriate diet, and maintaining normal weight. Keep checking out blogs to learn more about the comorbidities about other issues associated with migraines.

Dr. Sharisse Stephenson Dr. Stephenson is a Neurologist and a Board Certified Headache Specialist and Brain Injury Medicine Specialist. She has postgraduate training in neurological disorders and stroke management from Tufts University in Boston.

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