Migraine Aura And Stroke: Symptoms
Migraine and stroke are prevalent neurological conditions that have a significant impact on individuals and society. Over the years, researchers have proposed a connection between these disorders, and several theories have been suggested to explain the relationship between them. However, the exact causes of this bidirectional association remain unclear. We aim to provide an overview of the existing hypotheses regarding the correlation between migraine and stroke and explore potential recommendations for stroke prevention in individuals who experience migraines.
Migraine Aura and Stroke Risk
Migraine aura refers to sensory or visual disturbances that around one-third of migraine patients experience before or during a migraine attack. The symptoms of migraine aura are similar to the symptoms of retinal migraine. Studies suggest that migraine with aura is associated with a slightly higher risk of stroke compared to migraine without aura. In fact, the risk of stroke is doubled in patients with migraine with aura, both between migraine attacks (referred to as migraine-related stroke) and during attacks (known as migraine infarction).
Migraine infarction is a rare complication that can occur during an attack of migraine with aura. Its prevalence is approximately 1.4-3.4 per 100,000 individuals, accounting for 0.2% to 0.5% of all ischemic strokes. According to the International Classification of Headache Disorders (ICHD)-3, migrainous infarction is defined as a migraine attack with aura where one or more aura symptoms last longer than 60 minutes and neuroimaging reveals an ischemic brain lesion in the corresponding area. This condition predominantly affects young women with a history of migraine with aura
Aura Without Migraine Headache and Stroke Risk
The relationship between aura without migraine headache and stroke risk is less clear. Research is ongoing to understand whether aura itself or other factors contribute to the increased risk. It is important to consult with a healthcare professional to assess individual risk factors and determine appropriate management strategies.
The Link Between Migraine And Stroke
Some common hypotheses to explain the link between migraine and stroke are:
- cortical spreading depression (CSD)
- cardiovascular risk factors
- genetic risk factors
Cortical Spreading Depression, Stroke And Migraine
Cortical spreading depression (CSD) is the electrophysiological process responsible for migraine aura. It also contributes to the development of ischemic stroke, intracranial hemorrhage, subarachnoid hemorrhage, traumatic brain injury, transient global amnesia, and other conditions.
Genetics, Migraine And Stroke
A recent large-scale genome-wide analysis revealed a strong genetic overlap between migraine without aura and large artery stroke, as well as cardio-embolic stroke. However, genetic factors do not seem to play a significant role in the shared pathogenesis of stroke and migraine with aura
Cardiovascular risk factors
Migraineurs have an increased risk of various vascular events, including stroke. Consequently, the relationship between stroke risk factors and migraine has been extensively studied. The association between high blood pressure and migraine has shown inconsistent findings, with some studies suggesting a higher incidence of hypertension in migraine patients and others reporting contradictory evidence. Similarly, the relationship between migraine and obesity remains uncertain, although most studies indicate that obesity increases the risk of migraine and that the risk further escalates with higher body mass index (BMI). Obesity may also impact the frequency, severity, and duration of migraine and contribute to migraine chronification. This means that migraine can last longer.
Migraine and Stroke Risk Factors
While the exact mechanisms linking migraine and stroke are not fully understood, several shared risk factors have been identified. These include genetic predisposition, hormonal fluctuations, and underlying vascular conditions. Additionally, lifestyle factors such as smoking, high blood pressure, and obesity can increase the risk of both migraine and stroke. It is crucial for individuals with migraines to adopt a healthy lifestyle, manage risk factors, and work closely with their healthcare providers to minimize the potential for stroke.
Emerging evidence suggests that migraines are linked to white matter lesions, cardiac events, and vascular diseases. Among cardiovascular conditions that occur more frequently in individuals with migraines are hypertension, Reynaud’s syndrome, ischemic heart disease, and myocardial infarction, which are commonly associated with stroke
Does Migraine Cause Stroke?
Migraine does not directly cause a stroke. However, studies have shown that migraine, especially migraine with aura, may be associated with an increased risk of certain types of stroke, such as ischemic stroke. Ischemic stroke occurs when a blood clot blocks an artery supplying the brain. It is important to note that the overall risk of stroke in individuals with migraine remains relatively low. Understanding individual risk factors and implementing preventive measures can significantly reduce the potential for stroke.
Stroke-Like Migraine Symptoms
Stroke-like migraine, also known as migrainous infarction, is a rare condition characterized by symptoms that mimic a stroke, such as sudden severe headache, difficulty speaking, and weakness on one side of the body. It is essential to seek immediate medical attention when experiencing stroke-like symptoms to rule out an actual stroke and receive appropriate care. Prompt diagnosis and treatment can help manage the condition effectively and prevent further complications.
Complex Migraine and Stroke
Migraine refers to migraines with neurological symptoms that can mimic a stroke, such as temporary paralysis, confusion, or difficulty with speech. While these symptoms can be alarming, they are typically transient and resolve without causing permanent damage. However, it is crucial to differentiate between complex migraines and actual strokes to ensure appropriate treatment and prevent potential complications.
Migraine Aura and Stroke: Seeking Medical Evaluation
Individuals experiencing migraine with aura, ocular migraine, or any unusual migraine symptoms should consult a healthcare professional for evaluation. Medical assessment can help determine the underlying cause of these symptoms and identify appropriate treatment strategies to manage migraines and reduce the risk of stroke.
Tracking Migraine Aura And Stroke
Tracking migraine with aura has become easier and more efficient with the help of the Migraine Buddy app. This app offers a comprehensive platform for individuals to record and monitor their migraine symptoms, including the specific details related to aura experiences. With Migraine Buddy, users can log the onset, duration, intensity, and frequency of their migraines, as well as any associated aura symptoms they may experience. The app allows users to track triggers, medication usage, and the effectiveness of treatments, providing valuable insights into potential patterns and triggers for migraine with aura.