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Stroke and migraine

Around 15 per cent of women and five per cent of men experience migraine. Stroke and migraine share certain symptoms, which may lead someone with a migraine to fear they are having a stroke. A migraine is a type of headache, caused by spasms of the arteries leading into the head. A stroke is the interruption of blood to the brain, which kills the cells in the immediate area and affected those in the surrounding areas. The most common type of stroke is the ischaemic stroke, which is caused by an embolism (clot or debris) blocking a blood vessel in the brain. A migraine doesn't cause brain damage, either in the short or long term. A stroke results in brain damage that varies from mild to disabling. In severe cases, a stroke can cause coma or death. Despite the similarities in symptoms, it is possible to tell the difference between migraine and stroke.

Migraine aura
Around one in five migraine sufferers experience what are known as 'focal neurological symptoms' (migraine aura). Migraine aura often causes visual disturbances, such as flashing lights, zigzagging lines or partial loss of vision. Other symptoms may include numbness, tingling, speech difficulties and muscle weakness on one side of the body. These disturbing symptoms usually disappear within an hour. Unlike stroke, where similar symptoms are caused by an interruption of blood flow to the brain, migraine aura is thought to be caused by over-activity of the brain cells. The gradual onset of migraine aura is due to the slow spreading of hyperactive nerve activity across the brain surface.

Symptoms of stroke
Stroke and migraine aura can have similar symptoms. Depending on the area of brain affected, the symptoms of stroke may include:

  • Problems with vision, such as vision loss
  • Numbness and tingling of the face, sometimes on one side only
  • Speech disturbances
  • Muscle weakness, sometimes on one side of the body.
Transient ischaemic attack
Problems can occur if what's known as a transient ischaemic attack is mistaken for a migraine. A transient ischaemic attack (TIA) is a minor stroke and a powerful warning that a severe stroke may follow. The symptoms of a TIA are identical to those of a full stroke, but disappear within 24 hours. TIAs can appear hours, days, weeks or months before a full stroke. Just like full strokes, TIAs need emergency treatment. It seems that TIAs are caused by tiny blockages to blood vessels. These blockages cause temporary symptoms before they dissolve. Migraine aura and TIAs share similar symptoms, such as speech disturbances, weakness and problems with vision. Since the symptoms of TIAs go away within hours, the person may mistakenly believe they suffered nothing more than a migraine.

Differences between TIA and migraine symptoms
It is extremely dangerous for people to diagnose themselves and they should always seek medical advice. The broad differences between a migraine and a TIA include:
  • Visual disturbances - in TIA, the only disturbance is vision loss, whereas visual disturbance in migraine includes flashing lights and zigzagging lines as well.
  • Speed of attack - in TIA, the symptoms occur suddenly. In migraine, symptoms spread slowly over a few minutes.
  • Age of onset - migraine tends to first occur when an individual is young, whereas stroke is more common in older people.
Slightly increased risk of stroke
People who suffer from migraine may have a slightly greater risk of stroke. One study found that the risk of stroke for women in their 20s is 1.4 cases per 100,000. For young women with migraine, the risk rises to 4.2 cases per 100,000. The link between migraine and stroke risk is unknown. However, stroke is generally caused by a number of factors working in combination. Other factors which can increase the risk of stroke include the use of oral contraceptives and cigarette smoking. A young woman who experiences frequent migraine can reduce her minimal risk of stroke by quitting cigarettes and using other forms of birth control.

Treatment options
Recurring migraine should be medically investigated to confirm the diagnosis and to ensure appropriate and effective treatment. In some people, what seems to be a migraine aura may turn out to be stroke or a transient ischaemic attack (TIA). A person with a suspected stroke or TIA should seek medical advice immediately. If in doubt, see your doctor or call an ambulance.

Where to get help
  • Your doctor
  • In an emergency, call 000 for an ambulance.
Things to remember
  • Migraine and stroke may present similar symptoms, including visual disturbances, speech problems and weakness down one side.
  • People who suffer from migraine may have a slightly greater risk of experiencing stroke in the future.
  • You can reduce your risk of stroke by making healthy lifestyle choices, such as quitting cigarettes.

    Related articles:

Stroke - signs and symptoms.
Stroke - the after effects.
Stroke - the risk factors.
Stroke and high blood pressure.
Stroke can occur in children.
Stroke is a brain attack.
Stroke prevention.
Stroke prevention for high risk groups.

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Article publication date: 21/08/2001
Last reviewed: 31/08/2004

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