Stroke vs. Migraine

Migraine is the most common neurological disorder in the United States, affecting 10-15% of adults. Stroke is the #1 cause of long-term disability and the #3 cause of death in the U.S. Though stroke and migraine have different root causes, a migraine can sometimes mimic a stroke. Migraine sufferers, who are used to pain, may not recognize stroke symptoms, so it’s important to know the difference in order to seek medical attention; and when in doubt, call for help. 

Causes of stroke and migraine

Both stroke and migraine are caused by changes in the brain, but while migraines are extremely painful, they do not cause any damage to the brain. Strokes, however, can cause serious long-term damage. 

The causes of migraine are not well understood and may vary among migraine sufferers. It is believed that groups of brain cells become stimulated, causing a change in various hormone levels and the restriction of blood flow. Two of the main chemical culprits are serotonin and estrogen, which can cause changes in blood vessels. Since estrogen varies throughout the month in women who are not yet menopausal, migraines tend to be more common in younger women.

Migraines generally have an immediate trigger, such as:

  • Glaring or flickering lights
  • Stress or heightened emotions
  • Sudden changes in environmental conditions
  • Sleep disturbance
  • Certain food or drinks 

Ischemic strokes are caused by a blood clot in the brain or neck that cuts off blood flow to part of the brain. About 80% of strokes in the U.S. are ischemic. Hemorrhagic strokes are caused by a bleeding blood vessel either inside the brain or outside but within the skull or neck area. 

Strokes are associated with a number of medical risk factors, such as:

  • Diabetes and high blood pressure
  • Cancer
  • Heart disease
  • High cholesterol
  •  Inherited blood disorders, such as sickle cell disease
  • Hemophilia and other blood clotting diseases
  • Certain medications
  • Hospital stay and surgery 

Certain lifestyle risk factors include:

  • Heavy smoking
  • Heavy alcohol consumption
  • Obesity
  • Sedentary lifestyle
  • Poor diet, including processed foods, diet soda, and high saturated fats in the presence of high gluten consumption 

Symptoms of stroke vs. migraine

It can be challenging to know the difference between a stroke and a migraine. As mentioned, if you are in doubt, seek medical attention. Even doctors can have difficulty diagnosing the difference accurately. If your headache or symptoms persist, be sure to insist on a brain scan by a stroke team before accepting a migraine diagnosis. 

While everyone is different and strokes and migraines vary from person to person, here are a few differences to look for:

  • Migraine sufferers tend to experience them more than once, sometimes chronically, while a stroke generally comes out of the blue
  • While strokes can strike any age, they are more common as one gets older, while migraines tend to strike younger people, being especially common in the 20s and 30s
  • Migraines are not associated with the medical risk factors listed for strokes and are generally caused by triggers, while strokes tend to be caused by lifestyle or health factors
  • Migraines tend to come on gradually, while strokes come on suddenly
  • Migraines are often preceded by “aura” symptoms that can be confused with stroke symptoms, but there are differences: a migraine aura may cause visual issues of squiggly lines or flashing lights, while a stroke causes blurred or double vision. Both may cause dizziness or nausea, but stroke is likely to include balance and coordination issues. A migraine may cause disorientation due to pain, while a stroke causes disorientation due to mental confusion
  • Migraines may cause tingling or weakness in parts of the body, as stroke does, though stroke tends to feature more weakness and loss of feeling or numbness
  • Stroke often causes speech difficulties, which is not common with migraine
  • Migraines often cause heightened sensitivity to noise, light, and smells, causing more discomfort
  • Migraines cause “positive” symptoms (added sensations) while strokes cause “negative” symptoms (loss of sensation or skills) 

There does seem to be a link between stroke and migraine. According to the National Headache Foundation, people who experience migraines with aura are more than twice as likely to have an ischemic stroke as people whose migraines do not include aura symptoms. The reasons are not yet clear.

Addressing root causes

If you are a migraine sufferer, be aware of the differences between stroke and migraine so you can immediately recognize a stroke coming on. 

Talk to your doctor about your migraines in order to determine what may be causing them. If you have a hormone imbalance, consider changes in your diet or lifestyle and possible medications to help balance your hormones and improve stress levels to lessen your chances of another migraine attack. 

If you have any of the risk factors listed for stroke, start now to make changes to improve your health and lifestyle. Stroke risk should not be taken lightly. More than half of adults who experience a stroke have long-term damage from the stroke. You do not want to be among that statistic. 

If you’re at high risk for stroke, consider using Neuralert’s stroke detection system, which looks like a smartwatch and utilizes state-of-the-art AI technology to detect stroke symptoms in as little as 15 minutes, and 95% of strokes within an hour. Ask your doctor about adding Neuralert’s wristbands to your stroke-prevention plan.