Stroke

11 February 2009

Can migraine cause stroke?

The risk of stroke caused by a shortage of blood to the brain (or ischaemic stroke), is more than double in people suffering from migraine with an aura.

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The risk of stroke caused by a shortage of blood to the brain (or ischaemic stroke), is more than double in people suffering from migraine with an aura - a warning sensation that may occur before a migraine begins.

Every year, 18 out of 100 000 young, female migraine sufferers are at risk for ischaemic stroke. This risk is compounded in younger women with factors such as smoking and oral contraception. Studies have found that this is particularly the case in patients who experience more than 12 attacks per year and have been suffering from migraines for more than 12 years.

Approximately 20% of all migraines are associated with an aura, which is a reversible, abnormal visual disturbance, abnormality of speech, skin sensation or muscle weakness. The exact cause of a migraine is unknown, but a key factor may be the consecutive narrowing and expansion of blood vessels in the brain.

Two-way relationship
Subsequently, a complex two-way relationship exists between stroke and migraine with aura. A stroke can occur during a migraine with aura, and migraine with aura is a risk factor for stroke. A deficiency of blood to the brain (as occurs in an ischaemic stroke) can also induce a migraine with aura, which may be caused directly by the reduction in blood flow to the brain.

Migraine is a painful condition that often has a detrimental effect on the sufferer’s quality of life. However, all the available evidence suggests that migraine, as a primary headache disorder, is an essentially benign condition. It is still always advisable to consult a pharmacist or doctor regarding the management of migraine, in order to reduce any possible risk of a stroke effectively.

Compiled by Amayeza Info Services in the interests of patient education.

For more information about migraine, please contact the Migraine Patient Organisation on the Migraine Help Line (0860 – 678 268) or send an email to migraine@amayeza.co.za. Further information can also be found on the website www.mymigraine.co.za.

References:
1. Welch K, Bousser M. Relation between migraine and stroke. Lancet Neurology 2005; 4:533-542
2. Diener HC, Kurth T. Is migraine a risk factor for stroke? Neurology 2005; 64:1496-1497
3. Donaghy M, Chang CL, Poulter N. Duration, frequency, recency, and type of migraine and the risk of ischaemic stroke in women of childbearing age. Journal of Neurology, Neurosurgery and Psychiatry 2002; 73:747-750
4. Etminan M, Takkouche B, Isorna FC, Samii A. Risk of ischaemic stroke in people with migraine: systematic review and meta-analysis of observational studies. BMJ, doi:10.1136/bmj.38302.504063.8F (published 20 December 2004)
5. Goadsby PJ. Is migraine a progressive disorder? MJA; Volume 182 Number 3, 7 February 2005:103-104

The Heart and Stroke Foundation South Africa

 

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Stroke Expert

Dr. Ashleigh Bhanjan is a specialist neurologist at the Life Entabeni hospital in Durban. Dr. Bhanjan completed his internship at Johannesburg General hospital and his community service at Ladysmith Provincial hospital before qualifying as a Fellow of the College of Neurologists of South Africa in 2008. Since 2009, he has been practicing at the Life Entabeni hospital as a specialist neurologist with a particular interest in stroke neurology.

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