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By Gary Cohen
The Stroke-Migraine Connection
People who have migraine with aura are more than twice as likely to suffer a stroke.
Most migraine patients know their symptoms like they know their reflection in the mirror. But many of these symptoms— disturbances in vision and language, for example— can also be indicators of stroke. Although the absolute risk is small, recent studies show that people who suffer from migraine with aura have double, or even triple, the risk of stroke compared with people who don’ t get migraines at all. The exact connection between the two diseases is still unclear, but there are things you can do to lower your risk.
José Biller, MD, FACP, FAAN, FAHA, professor and chair of the department of neurology at the Stritch School of Medicine at Loyola University Chicago, has been a practicing neurologist for more than 30 years with subspecialty expertise in stroke and headache medicine. He recently sat down with Head Wise to discuss the migraine-stroke connection.
Head Wise( HW): How can people learn to recognize a stroke? Dr. Biller: The symptoms of stroke depend on the area of the brain that is affected. The most common manifestations are characterized by the sudden onset of a focal neurological deficit. That can be visual loss in one or both eyes, or in half of the visual field; speech or language impairment; weakness or paralysis in one part of the body— that can be in the face, the arm or the leg; numbness or tingling in one part of the body; unexplained headaches; unexplained dizziness or vertigo; or a combination of these symptoms.
HW: Recent research has solidified the connection between migraine and stroke. So how are the two diseases related? Dr. Biller: First of all, true migraine-induced stroke, or migrainous infarction, is very rare. Migraine is associated with a low absolute risk of stroke or mini-stroke, also known as transient ischemic attacks. The risk of stroke, though, is largely associated to the subtype of migraines with aura and most commonly occurs in women under the age of 45. That is magnified by other associated risks, particularly the consumption of tobacco and the use of oral contraceptives. The incidence of migrainous infarction varies if you have associated risk factors or not.
22 HEAD WISE | Volume 1, Issue 3 • 2011