
Migraines and strokes are two very different conditions, but they can share some similar symptoms. Both involve changes in the brain, which can make it challenging for people to know what treatment they should seek and when. In the case of a stroke, getting immediate treatment could be the difference between life and death, so it's critical to understand how to distinguish the symptoms.
Characteristics | Values |
---|---|
Overall feeling | Feeling unwell, disoriented, or abnormal |
Pain | Migraines are usually associated with pain, while strokes are not |
Vision | Blurred vision, flashing lights, zig-zags, sparks, blank spots, or double vision |
Vertigo | Both conditions are associated with dizziness or a spinning sensation |
Communication | Stroke victims are often unable to articulate their symptoms or communicate altogether |
Hypertension | Can be triggered by sudden bouts of extremely high blood pressure |
Other physical symptoms | Strokes typically cause one-sided weakness, numbness, partial vision loss, and speech difficulties |
What You'll Learn
Migraines and strokes can have similar symptoms
Migraines and strokes are two very different conditions, but they can share some similar symptoms. Both involve changes in the brain, which makes it challenging for people to know what treatment to seek and when. However, the results of a medical evaluation of these conditions are quite different, as is the treatment.
Similarities
- Disorientation: Both conditions can cause a sense of disorientation, although in a stroke, this is generally characterised by confusion, while the disorientation of a migraine is usually caused by extreme pain.
- Vision changes: The vision loss of a stroke is usually described as an area of blindness in one or both eyes, while the vision changes of a migraine are typically described as flashing lights or squiggly lines. However, a severe migraine can cause true vision loss.
- Vertigo: Both conditions are associated with dizziness or a spinning sensation. A stroke is far more likely to produce physical balance and coordination problems than a migraine.
- Feeling unwell: Both conditions produce an overall sense of feeling unwell. People who have migraine headaches are normally able to describe their symptoms in great detail, while people who have a stroke are often unable to describe their symptoms and are sometimes unable to communicate altogether.
- Abnormal feelings and behaviour: Both stroke and migraine may cause you to feel and act like you're not yourself. And both conditions can feel as if they are continuing to get worse with no end in sight.
- Pain: Migraines are usually associated with pain, while strokes are not typically associated with pain. However, sometimes strokes, particularly those caused by bleeding in the brain (hemorrhagic strokes) or tearing of the arteries (arterial dissection), do cause pain. The severe pain of a migraine can make it difficult to determine whether the overwhelming head pain is a stroke or a migraine. Often, the head pain of a stroke is sudden and overwhelming, while the pain of a migraine is typically more gradual.
- Other physical symptoms: Strokes typically cause one-sided weakness, one-sided numbness, partial vision loss, and speech difficulties. Migraines aren't usually associated with these symptoms, but on rare occasions, they can cause them.
- Hypertension: Sudden bouts of extremely high blood pressure can trigger a stroke or a migraine if you're already predisposed to these conditions.
Differences
- Migraines usually recur: A migraine is often a recurrent event. Most of the time, your first migraine doesn't produce neurological deficits such as weakness, loss of sensation, or vision loss. However, there are exceptions to this rule, and sometimes a person's first-ever migraine can be associated with neurological deficits.
- Migraines often have triggers: Migraines tend to be associated with triggers such as food, hormonal changes, stress, lack of sleep, loud noises, and chemical smells. A stroke is not normally associated with such everyday triggers and is more likely to be precipitated by extreme alterations in blood pressure or an irregular heartbeat.
- Stroke risk increases with age: Strokes are far more likely to affect individuals who are older than 60 and who have risk factors such as heart problems, hypertension, blood disorders, or high cholesterol. These risk factors are not associated with migraines, which generally start in your 20s or 30s; it's highly unusual for a person to begin having migraines after the age of 50.
- Migraines are temporary: One of the important differences between a stroke and a migraine is how long the episode lasts. A stroke is permanent, while a migraine is temporary. A stroke causes permanent brain damage due to a lack of blood supply to your brain, which injures your brain tissue, often leading to permanent disability. A migraine is a temporary event that eventually improves and doesn't cause brain damage.
When to seek medical help
If you are unsure whether you're having a stroke or a migraine attack, you should seek medical help as soon as possible. If it is a stroke or a TIA (transient ischemic attack), it's important to be reviewed and treated as soon as possible. If your symptoms have changed or you're experiencing aura for the first time later in life, it's also very important to be reviewed by a doctor.
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Migraines can increase the risk of stroke
While migraines have not been shown to cause strokes, people who experience migraines with aura are at a slightly higher risk of having an ischaemic stroke in their lifetime compared to those without migraines. This risk is especially pronounced in women under 45, women who use oral contraceptives, women who smoke, and people who get migraines with aura for the first time after the age of 50.
The risk of ischaemic stroke is also greater in people with frequent migraines, and in those who take birth control pills with high levels of estrogen. In fact, women with migraines with aura who take combination birth control pills with 50 µg or more of estrogen may increase their risk of stroke even further. However, there isn't enough evidence to determine whether this is true with today's lower estrogen doses.
The connection between migraine and stroke is complex and not yet fully understood. However, scientists have developed several theories regarding the link:
- Cortical spreading depression: This mechanism involves a wave of changes in the brain that spreads along the cerebral cortex, leading to reduced blood flow and inflammation.
- Genes: Certain rare gene mutations have been found to increase the risk of both stroke and migraine.
- Migraine medications: Ergotamines like dihydroergotamine (DHE) cause blood vessels to constrict, which could slightly increase the risk of stroke.
- Patent foramen ovale (PFO): The association between PFO, a hole in the heart that doesn't close after birth, and migraine is unclear due to mixed study results. However, some experts believe there's a link between PFO and migraine with aura. PFO has also been linked to certain types of stroke and transient ischemic attacks (TIAs).
Although the risk of stroke is higher in people with migraines, it is still considered low overall. People with migraines are generally younger, and this group tends to have a lower risk of stroke. As people age, their risk of stroke increases due to age and other factors such as high blood pressure.
If you are experiencing symptoms of a stroke, it is important to seek medical help as soon as possible.
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Migraines and strokes have different causes
While migraines and strokes share some symptoms, they have different causes. Strokes occur when the blood supply to the brain is interrupted, either due to internal bleeding or a clot in the artery. This interruption causes brain cells to be deprived of oxygen and nutrients, resulting in brain damage and often permanent disability. On the other hand, the exact cause of migraines is still uncertain, but they are thought to be related to problems with brain activity that affect nerves, chemicals, and blood vessels in the brain.
The symptoms of a stroke typically include slurred speech, balance issues, and a sudden headache. In contrast, migraine symptoms typically include a throbbing headache on one side of the head, nausea, vomiting, and sensitivity to light and sound. While both conditions can cause similar symptoms such as blurred vision, sudden confusion, and numbness or weakness on one side of the body, there are some key differences. For example, migraines usually recur and often have triggers such as food, hormonal changes, stress, and lack of sleep, while strokes are typically precipitated by extreme alterations in blood pressure or an irregular heartbeat. Additionally, stroke risk increases with age and certain health conditions such as heart problems, hypertension, blood disorders, or high cholesterol, whereas migraines generally start in a person's 20s or 30s.
Although the connection between migraines and strokes is not yet fully understood, some theories suggest that cortical spreading depression, rare gene mutations, and certain migraine medications may play a role in increasing stroke risk in individuals with migraines. It is important to note that having a migraine does not mean someone will definitely experience a stroke, but it is crucial to be able to distinguish between the two conditions as immediate treatment for a stroke is critical.
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Migraines and strokes have different treatments
While migraines and strokes share some symptoms, they are two distinct conditions with different treatments.
Migraine Treatments
Migraines are treated with medication, including:
- Over-the-counter pain relievers like acetaminophen (Tylenol), aspirin, and anti-inflammatory drugs like ibuprofen (Advil, Motrin)
- Triptans
- Ergot derivatives
- Medication to prevent episodes, including anticonvulsants, antidepressants, and beta-blockers
- Hormone therapy for women who experience migraines associated with their menstrual cycles
Other treatments for migraines include:
- Lifestyle changes, like eating a healthy diet, regular exercise, and reducing caffeine and alcohol intake
- Acupuncture
Stroke Treatments
Treatments for strokes include:
- Medication to dissolve the clot, such as tissue plasminogen (tPA)
- Medication to treat brain swelling or pressure
- Removing blood vessel blockages, such as carotid artery stenting, or treating aneurysms or arteriovenous malformations
- Rehabilitation, including physical therapy, to relearn basic reflexes and muscle skills
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Migraines and strokes have different durations
While migraines and strokes share some symptoms, they have different durations. A stroke is permanent, while a migraine is temporary. A stroke occurs when the blood supply to the brain is cut off, killing brain cells and causing permanent brain damage. On the other hand, a migraine is a temporary event that eventually improves without causing brain damage.
The duration of a migraine episode is typically shorter than that of a stroke. Migraines often recur, but they are usually triggered by factors such as food, hormonal changes, stress, lack of sleep, loud noises, and chemical smells. These triggers are not associated with strokes, which are typically caused by extreme alterations in blood pressure or an irregular heartbeat.
The duration of a stroke can be prolonged and may result in permanent disability. Most individuals who experience a stroke will have some level of disability and will need to undergo physical therapy and rehabilitation. In contrast, migraines are temporary episodes that usually last from a few hours to several days.
The difference in duration between migraines and strokes is crucial as it can help distinguish between the two conditions. While the symptoms of a migraine can be managed with medication and lifestyle changes, a stroke requires immediate medical attention to prevent permanent damage and improve the chances of recovery.
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