January 23, 2020

Women, Migraine and Stroke Risk

There has long been a link between migraines and stroke. Recent reviews of the medical literature have affirmed the connection. Much is known about the various triggers of migraines – certain foods, sleep or temperature changes, for example. But the underlying cause or causes of migraine are still fuzzy. Also unclear is the relation of migraine to stroke. As researchers continue to unravel this literal brainteaser, women with migraines can still take charge of their health to cut their stroke risk.

The mechanics of migraines

Migraines are considered vascular headaches. This means they relate to changes in the blood vessels. Migraines start when the trigeminal nerve, which supplies feeling to parts of the head and face, releases chemicals that cause blood vessels on the surface of the brain to swell. This triggers a cascade of pain signals that cause migraine symptoms. Migraines may also causes changes to the inside lining of these blood vessels, as well as how easily blood clots.

Some people with migraines have an aura that precedes the headache, while others do not. An aura is some type of sensation or feeling that comes on before the actual headache. Often the aura is a visual change that occurs in the hours or minutes before the headache sets in. The visual changes are typically described as flashing lights, zigzag lines, blurred vision or holes in the vision. Having migraine with aura seems to relate more strongly, perhaps exclusively, with risk of stroke…. and stroke

Migraine headaches, especially those with aura, are linked with ischemic stroke. This is the stroke type that is caused by a blood clot that blocks blood flow to the brain. When brain tissue is deprived of blood and oxygen, it dies.

The link

A recent review of the medical literature found the risk of stroke is double in women who have migraine with aura. This link between migraine and stroke appears highest for women under 45 years of age. Research also shows the risk is higher for women who smoked and took oral birth control pills. The overall risk for stroke in this group is still small, but women with migraines can make changes to reduce their elevated risks.

The exact cause-effect of migraines and stroke is still poorly understood. But, it may be related to the changes in blood vessels and blood clotting that occurs with migraines that trigger stroke.

What should I do if I have migraines to help lower my risk of stroke?

If you are a woman who has migraine headaches, consider carefully your choices for birth control. The risk of stroke is higher for women with migraine who take oral birth control pills. Be sure to tell your doctor you have migraines. Ask your doctor about what other forms of birth control might work well for you.

And don’t smoke. Smoking adds to the risk of stroke for women with migraine. There are many methods available to help you quit smoking. Nicotine replacement therapy and support can help you quit.