Migraines and strokes are neurological events that can significantly impact a person’s health. A migraine is a severe headache often accompanied by other symptoms like sensitivity to light or sound, while a stroke is a medical emergency where brain blood flow is interrupted. Though distinct, their symptoms can overlap, causing confusion. This article clarifies their relationship, detailing symptom overlap and differences.
Migraine Aura and Stroke Mimicry
Migraine aura refers to sensory disturbances preceding or accompanying a migraine headache. These neurological symptoms often resemble stroke signs, leading to stroke mimicry. Aura symptoms typically develop gradually over minutes and last less than an hour.
Visual auras, the most common type (90%), manifest as flashing lights, zigzag lines, or temporary blind spots. Sensory auras involve numbness or tingling, often spreading from fingers to face. Speech difficulties, like mumbling, are less common. These neurological symptoms can be mistaken for a stroke, especially if affecting one side. However, migraine aura symptoms are transient and fully reversible.
Migraine-Related Stroke
While migraines typically don’t cause permanent brain damage, a rare complication is migrainous infarction, where a stroke occurs during a migraine with aura. This rare event differs from symptom mimicry, accounting for only 0.5% to 1.5% of all ischemic strokes.
Diagnosing migrainous infarction requires migraine aura symptoms persisting over 60 minutes, evidence of an ischemic brain lesion on imaging, and ruling out other stroke causes. Risk factors include migraine with prolonged aura, and being a younger woman, especially if using oral contraceptives or smoking. The overall stroke risk linked to migraine is very low compared to other factors like high blood pressure or smoking.
Differentiating Symptoms
Distinguishing migraine aura from stroke symptoms is important due to overlapping presentation. Stroke symptoms typically appear abruptly and reach maximum intensity quickly. Migraine aura symptoms, in contrast, usually develop gradually over minutes, often spreading or evolving.
Symptoms also differ. Migraine aura often involves “positive” symptoms like flashing lights or tingling. Stroke symptoms are frequently “negative,” indicating a loss of function, such as sudden vision loss or complete numbness. While headaches can occur with both, migraine headaches often follow the aura, while stroke headaches tend to be sudden and severe. The FAST acronym (Face drooping, Arm weakness, Speech difficulty, Time to call 911) identifies stroke symptoms like sudden facial drooping, arm weakness, or slurred speech, indicating immediate medical attention.
When to Seek Medical Attention
Any sudden onset of new neurological symptoms, especially if severe or different from typical migraine patterns, warrants immediate medical evaluation. If stroke symptoms are suspected (e.g., sudden numbness/weakness on one side, trouble speaking, vision changes), call emergency services immediately. This prompt action is important because “time is brain” in stroke treatment, reducing brain damage and improving outcomes.
Avoid self-diagnosis; it’s safer to err on the side of caution with stroke-like symptoms. Consult a doctor for any new or worsening migraine patterns for proper diagnosis and management.