Migraine versus Stroke

A migraine and stroke may share some symptoms in common, which may lead someone with a migraine to wonder if they are having a stroke. With exception of certain cases of complicated migraines, most of the time the two present very differently and are distinguishable. That distinction may be based on finding a repetitive pattern over time (for example recurrent numbness that accompanies a headache and completely resolves in time, suggesting a migraine). Ultimately, is best to consult with a physician who would make that differentiation based on a careful neurological examination and brain imaging, if necessary.

A migraine is a type of a severe headache, comprised of a constellation of symptoms including nausea/vomiting, sensitivity to lights/sounds/smells. Sometimes a migraine is accompanied by an “aura”, which is a set of symptoms typically occurring prior to or alongside the head pain such as changes in vision, numbness or speech disturbances. Rarely, auras may be experienced without the headache itself. Often migraines begin in a young, otherwise healthy, individuals with a family history of headaches, which are exacerbated by stress, dehydration, poor sleep and skipping meals. A migraine is likely to be recurrent and stereotypical – a similar type of pain coming with similar accompanying features that one has for years. If a person experiences his/her typical migraine, and if a home treatment is established, then it does not require a visit to the emergency room.

A stroke, in contrary, is most often due to a blood clot in the brain, and may cause sudden changes in vision, speech and weakness on one side of the body (depending on the location of the blood clot). Strokes usually occur in middle-aged and older people with predisposition for it, like due to certain heart problems or blood vessel problems, uncontrolled blood pressure or a blood clotting disorder. On rare occasions a stroke may be accompanied by a headache.

A stroke always needs immediate medical attention. Therefore, if the cause of the symptoms isn’t clear and a stroke is suspected, or if a new severe headache starts or if there are new neurological symptoms (with or without a headache) or if there is a change to the usual migraine headache, it is important to seek medical care immediately.

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