Is my migraine a symptom of a stroke?

Some people fear that having migraines could mean they might also have a stroke. However it is very rare for a stroke and a migraine to occur at the same time, and there is no clear evidence to suggest that one causes the other. 

Stroke and migraine both happen in the brain, and sometimes the symptoms of a migraine can mimic a stroke. However, the causes are different. A stroke is due to damage to the blood supply inside the brain, but migraine is thought to be due to problems with the way brain cells work.

Migraine affects more women than men. Around one in every five women has migraine, compared to one in 15 men. It's most common in people aged between 30 and 40, and rates tend to decrease in people over 60. 

If you or someone you know has any new stroke-like symptoms, including a sudden, severe headache, weakness down one side, or slurred speech, call 999 right away. 

Find out more about the signs of stroke

Stroke risk and migraines

Although there is no evidence that migraine causes stroke, it's known that if you have migraine with aura you have a slightly increased risk of stroke. It isn't known why this is. 

This type of migraine is linked to a higher risk of having an ischaemic stroke, which is a stroke due to a clot in the blood supply to the brain. Compared to someone who doesn't have migraine with aura, you are twice as likely to have a stroke. 

This may sound high, but it's useful to know that on the whole, migraine affects people aged between 30-50. This age group tends to have a lower risk of stroke. So if you are in a younger age group, your chances of having a stroke are low even if you have migraine.

However, there are other big risk factors for stroke which can affect anyone at any age. Things like being smoker, having high blood pressure or being overweight all add to your risk of stroke. Overall, these are likely to have a much bigger impact on your health than migraine.

It's a good idea to learn more about how your lifestyle and health conditions affect you. You can find out about the main things that make a stroke more likely, and what you can do about them. To learn more about your individual risk of stroke, speak to your GP or pharmacist.

This information is a general guide, and it is not intended as a way of diagnosing migraine or stroke. You should get individual advice from a medical professional if you have migraine symptoms. If you have any stroke symptoms you must call 999. 

When migraine mimics stroke

The symptoms of some types of migraine can mimic stroke, such as hemiplegic migraine, which can cause weakness down one side. 

Migraine auras can be confused with transient ischaemic attack (TIA), as they both cause symptoms that pass in a short time. However, a key difference is that migraine aura symptoms tend to develop relatively slowly and then spread and intensify, while the symptoms of a TIA or stroke are sudden. 

Migraine headache may sometimes be mistaken for a stroke caused by bleeding on the brain, called a subarachnoid haemorrhage (SAH). However, the type of headache is usually different. In a SAH, the headache tends to be sudden and extremely intense. Migraine headache is usually one-sided and throbbing, and slower to come on. A SAH can also cause neck stiffness, which is uncommon during a migraine attack.  

Migraine with aura

About 30% of people with migraine have migraine with aura. Attacks typically begin with an ‘aura’ which develops gradually over five to 30 minutes and last less than one hour. The headache can occur with or after the aura.

If someone has aura symptoms without the headache it's sometimes known a a silent migraine.  

Types of aura include:

  • Visual changes such as flashing lights, zig-zags, sparks or blank spots. These can appear on one side or centrally, and commonly expand and move across your field of vision.  
  • Sensations such as pins and needles, tingling or numbness, weakness or a spinning sensation.

Oral contraceptive pill and migraine with aura

Taking the combined oral contraceptive pill (combi pill) increases the risk of stroke in women who have migraine with aura. Because of this, women who have migraine with aura are not usually given the combi pill. If you have migraine without aura you should be able to take the combi pill, unless you have other risk factors like smoking or being overweight.  

Migraine without aura

Around 70% of people with migraine have migraines without aura, which is sometimes called common migraine. It consists of a headache with other symptoms such as nausea and sensitivity to light, sound or smell. 

The other symptoms usually begin at the same time as the headache, and disappear once the headache goes. Many people feel irritable and need to rest in a dark room or sleep.

Hemiplegic migraines

A hemiplegic migraine is a rare type of migraine that can mimic stroke, as it causes weakness down one side of the body.

Hemiplegia means paralysis on one side of the body, and weakness or paralysis on one side is a key symptom of this type of migraine. Other symptoms might include:

  • Numbness or pins and needles.
  • Visual problems.
  • Confusion.
  • Speech problems.

These problems usually go away within 24 hours, but they may last a few days. A headache usually follows. 

Migraines with brainstem aura

This is another rare type of migraine, previously known as basilar-type migraine. People with this condition experience two or more of the following symptoms before a migraine:

  • Visual disturbances, including double vision.
  • Speaking difficulties.
  • Hearing problems, including ringing in the ears.
  • Tingling in the hands and feet.
  • Dizziness.
  • Vertigo.

People may experience these symptoms either ahead of or alongside typical migraine symptoms. 

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