migraine and stroke

1 December 2021

Migraine or Stroke? New Stats.

Yes, sometimes migraine looks like stroke. But let’s lay some important groundwork.

Most strokes are ischemic stroke. When there is a blockage to an artery going to the brain (such as a blood clot), the brain won’t get the oxygen it needs. Very quickly, brain cells begin to die. It’s a medical emergency.

Stroke is one of the leading causes of death worldwide, as well as a major cause of disability.

Typical symptoms include slurred speech or trouble understanding what others are saying, numbness or paralysis (often on one side of the body, such as half of the face), vision problems, dizziness, and a sudden headache. More helpful information can be found at the Mayo Clinic article about stroke. Scroll down for tips on what to do if you suspect a stroke.

Yes, other conditions can “mimic” stroke – but be on the safe side. If you have good reason to suspect a stroke, get the person to emergency treatment immediately.

To further complicate matters, migraine patients may be at increased risk of stroke (see for example these estimates).

But although it’s important to check for stroke right away, doctors and patients need to be aware that other conditions may mimic stroke. A recent study from Hungary gives us some more information.

For example, peripheral vestibular dysfunction was found to be the most common stroke mimic. This means dizziness, which can also mean problems walking properly, and nausea. This alone accounted for almost a quarter of the stroke mimics.

Migraine was down the list, but it still accounted for almost 8% of the stroke mimics. So to put this in perspective, if it looks like someone is having a stroke, less than 2% of the time, it may be migraine.

But there’s a way we can further narrow things down. If the patient is young, female, and at low risk of stroke, there’s a much higher chance that the symptoms are not, in fact, from stroke.

Why does this matter? You still need to go to the emergency room, right?

Yes, but it matters because once you’ve ruled out stroke, you still need to find out what’s going on, and treat it. Migraine is one of the main alternate culprits, because it, of course, can cause headache, but also dizziness, vertigo, paralysis, speech problems, and vision problems. So it’s important to treat, because it is also one of the leading causes of disability.

Find ways to reduce your stroke risk, and be sure to take migraine seriously as well.

Read more about this study here: Ischemic stroke mimics: A comprehensive review

26 July 2011

Cardiovascular System: More Links to Migraine?

James Information, News 1

A recent study (actually, a study of studies, known as a systematic review and meta-analysis) published in the journal Cephalalgia suggests that the risk of dissection of the cervical artery is twice as high for people with migraine. With all the links that have been found between migraine and heart disease, stroke, heart attack, and the like, it shouldn’t be a surprise that more links are being found.

What is cervical artery dissection? The cervical arteries are a set of four major arteries in your neck. Dissection occurs when the lining of one of these arteries becomes torn. It can become serious when clots form in the tears. Cervical artery dissection is a major cause of stroke in people under 50.

Because there are four arteries, even a clot often causes no problems. But a dissection can cause severe headache, pain in your face and neck, and other symptoms. Neck pain is often an early warning sign.

Because neck pain is common in migraine, sometimes a diagnosis of cervical artery dissection is missed.

If you’re experiencing symptoms of cervical artery dissection such as the above (stroke-like symptoms may be present as well), talk to your doctor. She will examine you and ask about your medical history, and possibly send you for more tests (various scans and ultrasounds may be used).

Dissections may heal up on their own, or you may need to take medication to deal with clots. But be sure to talk to your doctor if you think your symptoms may be more than migraine – especially if your symptoms have recently changed.

A summary of the study: Migraine, migraine aura, and cervical artery dissection: A systematic review and meta-analysis
More about Cervical artery dissection

4 May 2010

Migraine and Stroke in Young Adults and more

James Discoveries & Stats 4

A new study suggests another major link between migraine and stroke.

The most common single cause of stroke in young adults is something called cervical artery dissection. This is a problem with one of two major arteries in your neck. When the lining of one of the arteries becomes torn, the blood can clot and weaken the wall of the artery or actually block it.

This problem can heal on its own, but it can be serious not only because of the symptoms it can cause but because it can cause stroke before it properly heals.

We know that there seems to be an increased risk of stroke for migraine patients. So the question is, is there a correlation between migraine and cervical artery dissection (CAD)?

According to a new study, yes.

The study out of Finland was written up last month. The researchers took 313 CAD patients and looked for lifetime prevalence of migraine. They also looked at migraine type and CAD type.

Both men and women with CAD were significantly more likely to have migraine disease, particularly migraine with aura.

And another interesting note. When CAD occurred, often patients reported an alleviation of migraine – another interesting link that needs to be investigated.

What we want to do is narrow down exactly why migraineurs are more likely to be stroke victims. It looks like this may be an important link. There could be, for example, a genetic factor that is causing both migraine and CAD.

The researchers concluded: Our observations suggest that patients with CAD are a significant link between ischemic stroke and migraine.

14 August 2008

Migraine with Aura: the Gene that increases Stroke Risk?

James Discoveries & Stats 0

There’s been a lot of conversation about last month’s report on a genotype known as methyleneterahydrofolate reductase, or MTHFR 677TT. If you’ve read any of the reports, you may be as confused as I was at first, but let’s take a closer look.

There has been a lot of research into the connection between stroke and migraine. People with migraine, particularly specific types of migraine, do have an increased risk of stroke, according to modern research.

Now, this study involved 4577 Caucasian women who had a history of migraine (the study as a whole actually involved over 25,000 women). Over a quarter of those presently were dealing with migraine with aura.

The study followed the women for 12 years, specifically watching for cardiovascular disease.

The interesting thing about this gene is that it actually seems to decrease the risk of migraine with aura. However, if a woman has the genetic variation, and still develops migraine with aura, the risk of stroke takes a dramatic jump.

Women with the gene and migraine with aura had over three times the risk of developing cardiovascular disease. They had four times the risk of stroke, compared to women without the gene and without migraine with aura.

It’s too early to see this as a finished picture – it’s really only another small piece in the puzzle. It doesn’t look like the gene variant itself increases stroke risk – instead, there seems to be a connection between the gene and at least one type of migraine. How this all fits together is turning out to be very complex.

So what does a woman with migraine do with this information? Should she look into genetic testing? Dr. Tobias Kurth from the Harvard Medical School and one of the authors of the study says no. "At the moment, we’re not suggesting genotyping for women with migraines with aura. The consequences [of having this gene] are completely unclear right now."

Dr. Keith Siller, director of the Comprehensive Stroke Care Center at New York University’s Langone Medical Center explains that this may not even be the "right" gene – there is a connection, but it may be another gene causing the problem.

As we try to understand the link between stroke and migraine, there are a couple of things to keep in mind. First, the increased risk from migraine alone is not a reason to panic. Second, it is a reminder that we need to pay special attention to decreasing our risk in other ways – such as paying attention to our lifestyle and what we put in our bodies.

Dr. Kurth recommends: "Doctors should try to reduce heart disease risk factors and advise young women who experience migraine with aura not to smoke and to consider birth control pill alternatives as these increase the risk of ischemic vascular problems."

And we wait until the puzzle is more complete…

For more, read Gene May Put Women With Migraine At Increased Risk Of Heart Disease And Stroke, Gene Linked To Migraine and Increased Stroke Risk, and Interrelationships among the MTHFR 677C>T polymorphism, migraine, and cardiovascular disease

5 February 2005

Genetics and the stroke migraine connection

James Discoveries & Stats, Tips 0

You want to know more about the genetics of migraine? So does Lyn Griffiths. Lyn and her team have been studying migraine for over 9 years from a genetic standpoint. If you want to read a really good article on her research, check out this one from July (link no longer available). It gives a great summary of some of the methods used, and where Lyn believes the research is heading.

One interesting thing that is not mentioned in the article is their research into the link between stroke and migraine. Of course you’ve heard a lot about that recently, but way back in September 2003 Lyn’s team discovered a genetic link. Interestingly, the biochemical imbalance that this genetic flaw causes may simply be treatable through diet. “By increasing folate levels in the diet, such as eating green leafy vegetables, this biochemical imbalance decreases, which consequently may reduce the risk of stroke and possibly migraine.”

Everybody’s telling us we’re not eating enough leafy greens anyway, here’s another good excuse. Folate has been in the news again for other reasons – a January issue of the Journal of the American Medical Association reported on a study that showed heart benefits from folate (a B vitamin). Excellent sources include oranges, dark leafy greens, wheat germ and legumes. Of course, we’ve known about vitamin B for a long time – it’s in the successful natural supplement for migraine, Migrelief.

Read the 2003 press release from the Genomics Research Centre where Lyn Griffiths works [link no longer available].