Stroke & Migraine with Aura: Prevention
Each year approximately 55,000 more women than men experience a stroke. In recognition of this, the American Heart Association and American Stroke Association collaborated to develop a set of guidelines for reducing the risk of stroke in women.
Living with Migraine with Aura (but NOT Migraine without Aura) is associated with an increase in stroke risk, though the increase is incredibly modest. Some important things to know:
- Migraine attacks are very rarely associated with stroke.
- Women are four times more likely than men to live with Migraine, making the need for more information about reducing stroke risk among this population readily apparent.
- Migraine with Aura is accounts for an additional four cases of stroke per 10,000 women when Migraine with Aura is assumed the primary cause of the stroke.
- Migraine with Aura doubles the risk for ischemic stroke in women.
- Migraine with Aura is associated with an increase in hemorrhagic stroke among women, particularly those with fatal hemorrhagic stroke or over age 55.
- When a diagnosis of Migraine with Aura is combined with additional risk factors, there is more reason for concern. Smoking and/or use oral contraceptives increases the risk of stroke among women who live with Migraine with Aura.
- Among pregnant women with a diagnosis of Migraine there is a large association with hemorrhagic stroke and preeclampsia/eclampsia (high blood pressure).
- Women with Migraine with Aura who experience a stroke seem to have a good likelihood of recovery.
Unfortunately the group developing these guidelines does not believe there is sufficient information to recommend specific approaches to treatment of Migraine to reduce stroke risk. Therefore, the committee refers back to the existing primary prevention guidelines for stroke and Migraine with Aura issued in 2011.
The primary prevention for guidelines among patients with Migraine with Aura are:
- "Because there is an association between higher migraine frequency and stroke risk, treatments to reduce migraine frequency might be reasonable, although evidence is lacking that this treatment reduces the risk of first stroke."
- "Because of the increased stroke risk seen in women with migraine headaches with aura and smoking, it is reasonable to strongly recommend smoking cessation in women with migraine headaches with aura."
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