While more studies are needed to determine whether preventing migraine actually decreases the risk of stroke, experts also recommend appropriate headache management with preventive medication, cognitive behavioral therapy, and lifestyle changes. In particular, oral contraceptives with ethinylestradiol or estrogen supplements may increase the risk for blood clots in women who experience migraines with aura. Finding alternative birth control methods to oral contraceptives may also be an important option for some women. 5 That includes better management of lifestyle factors such as getting adequate exercise, not abusing alcohol, smoking cessation as well as keeping weight, blood pressure, blood lipids, and blood glucose under control.įor women, smoking cessation is especially important. Regardless of the origin, experts recommend managing traditional risk factors for vascular disease and stroke to prevent migraine-related stroke. Other origins may include stroke-related neuro-excitability and neuroinflammation, damage to neural pain pathways, and genetic risk factors. The pathophysiology is less clear for post-stroke headache, but it may also involve a vascular origin as a result of blood vessel injury or inflammation from a stroke. Factors that also increase the risk of clots, such as oral contraceptives, may further increase the risk of ischemic stroke. As the blood vessel constricts, its lumen narrows, increasing the risk for blood clots and stroke. According to this view, arterial spasm contributes to the development of migraine. One school of thought points to a vascular origin. Nevertheless, some experts believe the two may have similar pathophysiology. While persistent post-stroke headache was recently added to the International Classification of Headache Disorders, more research is needed to identify features that distinguish post-stroke headache from stroke-related migraine. The study could not distinguish headache characteristics, such as migraine with and without aura. Headaches developed about six months after the patient’s stroke, and arteriopathy was significantly linked to post-stroke headache. 4 Among these patients, 32% had new onset headache. A recent retrospective study of 115 children aged 30 days to 18 years seen at Lurie Children’s Hospital of Chicago found that 30% experienced post-stroke headache after suffering an ischemic stroke. Research further suggests that stroke may increase the risk for migraine in children. 3 While post-stroke headaches tend to have tension-type features with more frequent and severe symptoms than stroke-related headaches, risk factors are similar: female sex, younger age, pre-existing headache disorder, and comorbid depression. Up to 23% of adults develop persistent post-stroke headache, according to a recent review. On the flip side, stroke may also increase the risk for headache. Being younger than 45 years old, smoking, and oral contraceptive use among women were also risk factors for stroke-related migraine. About three-quarters of migraine sufferers are women, and risk for ischemic stroke was double for women with migraine, compared to men with migraine. 2 Women, in particular, were at increased risk. So how should doctors counsel their patients about this link and stroke prevention?Īccording to the new meta-analysis, people who suffered from migraine with aura had two times increased risk of ischemic stroke compared to migraine sufferers without aura. 1 Now, new research indicates a specific link between migraine with aura and ischemic stroke. Of the 800,000 strokes that occur each year in the US, about 2000 to 3000 may be related to migraine, according to the American Migraine Foundation.
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