Migraine-Associated Stroke

Migraine is a common headache disorder characterized by symptoms that typically occur over several hours to a few days. Migraine-associated stroke (also known as migrainous infarction or migraine-induced stroke) is an uncommon complication of migraine identified by ischemic stroke on neuroimaging that corresponds to prolonged aura symptoms in a patient with migraine.
The reported incidence of stroke due to migraine (migrainous stroke) ranges from 0.8 to 3.4 per 100,000 per year.
Clinical factors associated with an elevated risk of stroke in patients with migraine include:
-Patients with migraine with aura
-Female patients
-Patients who smoke
-Patients who take estrogen-containing contraception
-Patients age <45 years Clinical symptoms of migraine-associated stroke are typically similar to previous migraine aura without new or atypical symptoms. However, the previously transient aura symptoms persist for longer duration. Migrainous infarction occurs in a patient with migraine with aura that is typical of previous attacks except that one or more aura symptoms persists for >60 minutes. Neuroimaging demonstrates ischemic infarction in a relevant area.
Both cerebrovascular events and migraine attacks can present as acute transient neurologic events with similar symptoms. In addition, acute neurologic symptoms that are persistent may also be caused by either migraine or stroke.
For new or alarming symptoms persisting for longer duration, please seek emergency or urgent care. For an evaluation for ongoing care, please make an appointment with one of our caring providers today.
–Alice Wong, NP