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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.”

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

1. Cheryl Bushnell, et al. "Guidelines for Prevention of Stroke in Women." Stroke. Published online before print, February 6, 2014. DOI: 10.1161/ 01.str.0000442009.06663.48.


  • barryolliver
    6 years ago

    Once or twice a year, I end up at the hospital’s accident and emergency department after suffering what appears to be a stroke. So far they have all been false alarms – just a severe migraine attack. Although I usually don’t remember much of the actual incidents, I always hate being kept in for observation for 24 – 48 hours. The noise, lights and bustle of the emergency room and even the ordinary ward are extremely unpleasant. In fact I would describe it as torture. It’s very seldom that the nursing staff or doctors understand how painful the hospital environment is when one has a severe migraine.

    I’m seriously thinking of putting a prominent notice in my wallet that I’m having a migraine attack and not a stroke and not to take me to hospital. But then as I’m a male in my mid sixties, I wonder if that is a wise idea…

  • Katie M. Golden moderator
    6 years ago

    I like your line of thinking. However, I think the note in your wallet should state your name, address, diagnosis of migraine with stroke-like symptoms, list of medications you are on and contact info for a friend or family member. It’s probably a good idea for you to be taken to the hospital (although it can be a pain). Who knows when there is one time that some new condition could be discovered that could save your life.

    Of course, maybe you should also consider wearing a Medic Alert Bracelet.

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