Migraines And Strokes: What's The Link?

Migraines are recurring, throbbing headaches that affect around 30 million Americans and are often accompanied by nausea, weakness, and sensory disturbances. While migraines themselves do not cause strokes, they may increase the risk of experiencing one, particularly in women under 45 who are on hormonal birth control. This is because birth control can increase the risk of blood clots, and migraines are associated with spasms in the artery, which can lead to clots and cause a stroke. This occurrence is known as a migrainous stroke or migrainous infarction and is considered rare, accounting for only 0.8% of all strokes.

Migraines don't cause strokes but can increase the risk

While migraines don't cause strokes, they can increase the risk of having one. This is especially true for people with a history of migraines with aura, a set of symptoms preceding the migraine such as flashes of light or tingling in the face or hands. The risk is also higher for women aged 45 and younger, with or without oral contraceptive use, and for people who smoke.

The connection between migraines and strokes is not yet fully understood. However, research has shown that people with migraines, especially those with aura, have a higher risk of ischaemic strokes, which are caused by a blood clot. This type of stroke accounts for most cases. In people with migraine, the risk of haemorrhagic strokes, caused by weakened blood vessels supplying the brain, is unclear.

Migraines with aura can sometimes be mistaken for transient ischaemic attacks (TIAs) or 'mini-strokes', which are temporary interruptions of the blood supply to the brain. A TIA may last a few minutes or up to 24 hours. Migraines and ischaemic strokes can also occur together, known as a migrainous infarction or migrainous stroke, which is considered rare.

The symptoms of a migraine with aura can include visual disturbances such as blind spots or zig-zags, numbness or tingling, difficulty speaking, and dizziness. These can be similar to the symptoms of a stroke or a TIA, which can make it challenging to distinguish between them. Generally, migraine symptoms tend to come on gradually and include 'positive' symptoms such as flashes of light, while stroke or TIA symptoms tend to come on suddenly and include 'negative' symptoms such as loss of vision or feeling.

If you are unsure whether you are experiencing a migraine attack or a stroke, it is important to seek medical help as soon as possible.

Migraines with aura double the risk of ischaemic strokes

Migraines with aura have been shown to double the risk of ischaemic strokes, but it is important to note that the overall risk of stroke for migraine sufferers is still considered low. The risk is higher in women, especially those under 45, and in people who are otherwise young and healthy.

A migraine is a chronic or episodic neurological disorder characterised by a throbbing or pulsating unilateral headache lasting for 4-72 hours. It often runs in families and affects around one in five women and one in 15 men.

A migraine with aura is a type of migraine that occurs alongside a set of symptoms known as an aura, which usually precedes the migraine. An aura can include visual disturbances, such as flashing lights, zig-zags, sparks or blind spots, as well as sensory symptoms like pins and needles, tingling, numbness, weakness, vertigo, difficulty speaking or hearing, and fear or confusion.

An ischaemic stroke is a type of stroke caused by a blood clot, which accounts for most cases of stroke. It occurs when the blood supply to the brain is blocked, cutting off the blood supply and killing brain cells.

Population-based studies have shown a close relationship between migraines and strokes, with migraines, especially those with aura, being a risk factor for ischaemic strokes. The exact mechanism linking the two is still unclear, but it appears to be independent of traditional cardiovascular risk factors.

While having migraines with aura is a risk factor that cannot be helped, there are ways to manage other risk factors for strokes. Controlling high blood pressure and high cholesterol, as well as managing other conditions such as arterial hypertension or diabetes, can help reduce the risk. Women with migraines with aura should also carefully consider their options for oral contraceptives, as these can further increase the risk of ischaemic stroke.

Migraines, oral contraceptives, and increased risk of blood clots

Migraines are more prevalent in women than in men, with 18% of women and 6% of men experiencing them. This is largely due to hormonal changes, which can also be managed or prevented through the use of hormonal contraceptives. However, for women who experience migraines with aura, the use of combined oral contraceptives (COCs) can heighten their risk of stroke.

Aura is a series of visual and sensory changes that may include:

• Inability to speak clearly
• Seeing black dots, zig zags or other unusual visual patterns
• Tingling and numbness on one side of the body

These symptoms typically occur right before or during a migraine attack and can last from 10 minutes to half an hour. About a quarter of people who experience migraines also have aura.

Stroke Risk

Women under 45 who experience migraines with aura are already at a higher risk of ischaemic stroke. This may be due to an increased likelihood of forming blood clots due to inflammation, abnormalities in coagulation, and dysfunction of the blood vessels. The use of COCs further increases this risk, especially in women with other risk factors such as smoking, high blood pressure, high cholesterol, or obesity. This is because oestrogen, which is found in most COCs, can cause the blood to clot more easily.

Alternative Contraceptive Options

For women who experience migraines with aura, progestin-only contraceptives do not appear to increase the risk of stroke and cardiovascular disease. Women who are at high risk of stroke should consider non-oestrogen contraceptive options.

Weighing the Risks and Benefits

While the use of COCs can increase the risk of stroke in women who experience migraines with aura, it is important to note that the overall risk of stroke is still considered low in this group. Women who are young and healthy, with few vascular risk factors, may still be good candidates for COCs. It is important to discuss the risks and benefits with a healthcare provider to determine the most appropriate form of contraception.

Migraines and stroke: symptoms and diagnosis

Migraines are recurring, throbbing headaches that can cause nausea and weakness and affect around 30 million Americans. While migraines themselves are not strokes, they can increase the risk of experiencing one, especially in women under 45. This is because oral contraceptives, which are often used by younger women, can increase the risk of blood clots, which are a cause of ischaemic strokes.

Migraine symptoms

Migraines usually affect only one side of the head and are often accompanied by nausea, vomiting, and extreme sensitivity to light or sound. In some cases, the pain may switch sides with each migraine.

A migraine with aura refers to when the headache is accompanied by sensory disturbances such as flashes of light, zigzag lines, tingling sensations, and difficulty speaking. These symptoms can last for over an hour and then slowly disappear.

Stroke symptoms

Strokes occur when the blood supply to the brain is interrupted, resulting in brain cell death. Ischaemic strokes, the most common type, are caused by blood clots, while haemorrhagic strokes are caused by weakened blood vessels that burst and interrupt blood flow.

Symptoms of a stroke include:

• Numbness or weakness in the face, arm, or leg, especially on one side of the body
• Sudden trouble speaking
• Vision problems in one or both eyes
• Difficulty walking
• Dizziness, loss of balance, or coordination
• Severe headache with no known cause

Diagnosis

If you are experiencing any of the symptoms of a stroke or migraine with aura, it is important to seek medical attention as soon as possible. A physical exam and a detailed review of your medical history, including any previous migraine symptoms, can help with diagnosis. Imaging tests such as MRIs and CT scans can also be used to observe the affected areas of the brain and determine if there are any blockages or interruptions in blood flow.

Migraines and stroke: treatment and prevention

While migraines are not a direct cause of strokes, there is a link between the two, and people who suffer from migraines may have a higher risk of stroke. This is especially true for women under 45, who are at double the risk of an ischaemic stroke if they experience migraines with aura. This risk is even greater if they are taking oral contraceptives or if they smoke.

The exact mechanism behind the link between migraines and strokes is not yet fully understood. However, it is thought that the spasm in the artery that occurs during a migraine, combined with the increased risk of blood clots due to hormonal birth control, may lead to the formation of a clot that can cause a stroke.

If you experience migraines with aura, it is important to be aware of the signs and symptoms of a stroke and to seek medical help as soon as possible if you experience any of these symptoms. Some symptoms of a migraine with aura that may be similar to those of a stroke include:

• Visual disturbances such as blind spots, zig-zags, or flashing lights
• Numbness or tingling in the face, hands, or arms
• Dizziness or loss of balance
• Sensitivity to light or sound

To reduce the risk of stroke, it is recommended that individuals with migraines with aura focus on managing other vascular risk factors such as high blood pressure, high cholesterol, and conditions such as arterial hypertension or diabetes. Women with this type of migraine should carefully discuss oral contraceptive options with their doctor, as these can further increase stroke risk.

If you are experiencing a migraine and are unsure if you are also having a stroke, it is always best to seek medical help as soon as possible. A doctor can perform tests such as a CT scan or an MRI to rule out a stroke as the cause of your symptoms.

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