If you are a woman who has migraine with aura, you are slightly more likely to get an ischemic stroke. That’s when a blood clot blocks the flow of blood to your brain, causing a medical emergency. If you have an ischemic stroke during a migraine with aura attack, doctors call that a “migrainous infarction.”
It’s important to know that the overall risk for this type of stroke is small. An expert with the American Migraine Foundation puts it this way: There are about 800,000 strokes in the U.S. each year, and about 2,000 to 3,000 may be linked to migraine.
Still, it’s a good idea to be aware of migrainous infarction symptoms, risk factors, treatments, and ways you can help prevent this problem.
Who’s at Risk for a Migrainous Infarction?
The chances of having a migrainous infarction appear to go up if you’re a woman under 45 years old who has migraine with aura along with any of these stroke risk factors:
If you use birth control pills that include estrogen, that might also raise your risk.
At least one headache expert says that some people living with migraine don’t appear to have a significant stroke risk: women who have migraine without aura, and men who have migraine with or without aura.
It’s not completely clear why that is. Another expert says that migraine with aura can temporarily narrow blood vessels, making blood clots more likely to form, and that could raise the chances for a stroke if you are a younger woman who has migraine with aura along with one or more stroke risk factors.
What Are the Symptoms of Migraine With Aura?
Migraine is a neurological disorder that brings on pounding, throbbing, or pulsating headaches. It can also set off symptoms like nausea, vomiting, and sensitivity to light, noise, or scents.
Three times more women live with migraine than men, and researchers say that hormones play a role.
About 25% to 30% of people living with migraine also go through a phase called “aura” that affects their senses. Aura comes on shortly before the headache portion of a migraine attack.
The symptoms of aura usually last about 20 to 60 minutes. At least one of the symptoms of a stroke has to last more than 60 minutes for you to be diagnosed with a migrainous infarction.
It’s most common for aura to affect your sight, bringing on signs like:
- Flashes of light or sparks
- Blind spots
- Shapes, such as stars and zigzagging lines
- Blurry vision or loss of vision
Aura may also make you feel tingling or numbness in your face, body, hands, and fingers. It can affect your ability to speak clearly, too, causing you to slur or mumble words.
What Are the Symptoms of a Stroke?
A stroke is a medical emergency that can lead to long-term brain damage, disability, or death. But the sooner you get treatment at the hospital, the less damage it can do. That’s why it’s crucial to learn the warning signs of a stroke and call 911 if you think you’re having one.
A stroke can bring on symptoms like sudden:
- Weakness or numbness in your face, arm, or leg, often on side of your body
- Trouble talking or having a hard time understanding speech
- Problems walking, such as losing your balance, struggling to coordinate your movements, or getting dizzy
- Trouble seeing out of one or both of your eyes
- A severe headache with no clear cause
Women can also have stroke symptoms like:
- Feeling weak or unusually tired
- Getting disoriented
- Having memory problems
- Getting nauseated or throwing up
Since certain migraine and stroke symptoms overlap, think of the initials F.A.S.T. to help you remember the key signs of a stroke:
“F” for Face drooping. One side of your face sags or feels numb. For instance, when you try to smile, it could look uneven.
“A” for Arm weakness. One of your arms becomes weak or feels numb. When you try to raise both of your arms, one of them may drift down.
“S” for Speech problems. A stroke can cause you to slur words.
“T” for Time to call 911. If you think you’re having any symptoms of a stroke, you need to call an ambulance right away. Ambulance paramedics can start giving you lifesaving treatment on the way to the emergency room if you need it. Don’t drive yourself to the hospital or ask a loved one to drive you.
Once you’re at the hospital, your care team may:
- Ask you when your stroke symptoms started
- Discuss your medical history
- Scan your brain with an imaging test
What Are the Treatments for Migrainous Infarction?
Migrainous infarction treatment involves stopping the ischemic stroke you’re having.
Getting diagnosed and treated fast is key. If you get to the hospital within 3 hours of your first stroke symptoms starting, your doctor may be able to give you an IV injection of medication called a thrombolytic, which breaks up the blood clot causing the stroke. It could boost your chances to make a full recovery or have less disability.
Other treatment options are:
- Delivering clot-busting medication straight to the brain through a long, thin tube called a catheter, which can be threaded from an artery in your groin up to your brain.
- Using a device attached to a catheter to remove the blood clot from the blocked blood vessel in your brain. This procedure can help people who have a large blood clot that can’t be dissolved with medicine alone.
Your doctor might also try to lower your chances of having another stroke by doing a procedure to open up an artery that’s narrowed by a buildup of plaque.
How Can You Help Prevent Migrainous Infarction?
As you follow your migraine treatment plan to prevent or ease migraine attacks, you also can make healthy lifestyle changes to lower your chances of having a stroke:
If you smoke, quit. You can ask your doctor and loved ones to help you kick the habit.
Get regular exercise. Gradually work up to 150 minutes of physical activity a week. If you’re not active now, you can ask your doctor for help getting started.
Stay at a healthy weight. A balanced diet and exercise can help you do that.
If you drink alcohol, enjoy it in moderation. Limit it to one drink a day if you’re a woman and two if you’re a man.
Talk to your doctor if you take birth control pills that contain estrogen. Some experts recommend that you avoid taking these if you have migraine with aura and use another birth control option instead, like progestin-only pills. If you’d prefer to take pills that include a combination of estrogen and progestin, recent research suggests that you can weigh the benefits and risks with your doctor.
Let all your doctors know you have migraine with aura. Ask your primary doctor if you should get checked once a year for conditions that can raise your chances of having a stroke, like high blood pressure, high cholesterol, diabetes, and obesity.
There’s another good reason to let everyone involved in your health care know that you have migraine with aura. Women living with the disorder often show mild brain changes on MRI imaging tests. They’re called white matter lesions, and they usually look like small black holes on an MRI scan. If the radiologist who analyzes your MRI doesn’t know you have migraine with aura, they might mistake the holes for signs of a stroke or multiple sclerosis. So, speaking up could help you avoid a scary misdiagnosis.