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Why do people who suffer migraine with aura are more at risk for stroke?

Why do people who suffer migraine with aura are more at risk for stroke? And does this mean that all individuals with aura will have a stroke?

I had migraine with aura since about age 10 and at nearly 38 I still suffer them. I'm terrified that I will have a stroke according to the statistics I read about. My neurologist doesn't say much about this and doesn't seem concerned. So I'm just wondering who else out there has the aura and is the risk high for us.

  1. Although my neurologist has never made the connection directly (ie: he’s never said “because you experience migraines, you’re at a higher risk for having a stroke”), he has explained that I’m at an extremely high stroke risk because the peripheral branches of my MCA (middle cerebral artery) are spamming bilaterally. He’s explained that I’ve definitely had at least one TIA (and I recently had another one, so we can make that at least 2 TIAs now). He’s also said that the MCA spasms are either the cause or result of my migraines -but he has no clue which it is ...and that it’s weird that BOTH branches are spasming -and that the TIAs have been bilateral as well. Sooooooo, there’s definitely a connection -the nature of which doesn’t seem to be understood. I’ve been told to not worry and that all I can do is simply keep extra-strength aspirin on hand (as an emergency blood thinner), and to recognize the early stages of a stroke -and to pop an aspirin & get myself to the ER asap when the next one happens (note: a TIA = a stroke that resolves itself).

    1. I have the family history of stroke so that makes me at a higher risk. When I read that migraine with aura had higher stroke risk also I tried to find the actual number per 1,000 to put it in perspective. It actually depends on age and other factors such as smoking and taking the pill. Here is an interesting article.

      https://www.migrainetrust.org/about-migraine/migraine-what-is-it/stroke-migraine/

      1. From the way it was described to me, it isn't necessarily that migraine with aura causes strokes, only that people who have migraine with aura are more likely to have a stroke. A case of correlation is not causality.
        The best you can do is take care of yourself and ensure that you know the signs. Just be warned, migraine with aura can look like a stroke and a stroke can start out looking like a migraine. Source: I have had a stroke, a multitude of TIAs (about a dozen if you only count the ones that landed me in the hospital, in the hundreds if you also count the ones that lasted < 1 hour), and have familial hemiplegic migraines (which mimic a stroke, fun telling the TIAs and migraines apart).

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