Stroke or Migraine? How to Know the Difference.

Stroke or Migraine? How to Know the Difference.

You’re hit suddenly with a blinding headache. Maybe you’ve had migraines before and this feels like another one. Or maybe you’ve never had a migraine but imagine this is what one must feel like. You might be right, but what if you’re not? Just like stomach pain and chest pain, a bad headache can indicate a number of conditions that have similar or overlapping symptoms. Since both stroke and migraine are common neurovascular disorders with many neurological and physical similarities, your throbbing head could be a migraine mimicking a stroke or a stroke disguised as a migraine. So which it is: stroke or migraine? Knowing the difference could save your life.

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Stroke or migraine? The migraine-stroke connection.

Migraine is the most common neurological disorder, affecting 10% to 15% of adults in the U.S. According to a study published in the Journal of Stroke, people who suffer from migraine headaches have increased risks for a variety of vascular diseases, including ischemic stroke and hemorrhagic stroke.

The National Headache Foundation reported that people who have migraine with aura (additional symptoms that typically appear before a migraine begins) are more than twice as likely to have an ischemic stroke as people who have migraine without aura. In addition to a severe headache, it is these aura symptoms that can mimic some of the signs of a stroke or transient ischemic stroke (TIA).

Stroke and migraine with aura overlapping symptoms.

  • Visual changes
    • Stroke:
      • Sudden trouble seeing in one or both eyes
    • Migraine with aura:
      • Flashing lights
      • Spots or zigzag lines
      • Temporary, partial loss of vision
    • Speech changes
      • Stroke:
        • Sudden confusion, trouble speaking or understanding speech
      • Migraine with aura:
        • Speech difficulties and disturbances, confusion
      • Physical changes
        • Stroke:
          • Sudden numbness or weakness or face, arm or leg, especially on one side of the body
          • Sudden trouble walking, dizziness, loss of balance or coordination
        • Migraine with aura:
          • Weakness in arm or leg
          • Numbness or tingling in the face or hands
          • Lightheadedness

Man-headache-FB.jpgAs you can see, it can be very difficult to tell whether someone’s having a stroke or migraine with aura because the symptoms can be nearly identical. As if to complicate matters even more, people who suffer from seizure disorders can also experience aura symptoms. This is why it’s so important to have any of these symptoms checked out by a medical professional, especially in the case of a stroke where time is brain.

Recognizing a stroke is key, according to Albert Yoo, MD, a neurologist at Medical City Plano. Dr. Yoo says that because treatment is time dependent, every minute that passes without medical care means more brain cells are dying.

Stroke or migraine? How to recognize the differences in symptoms.

While it’s always advisable to seek emergency medical treatment by calling 911 for any signs of stroke, even if you’re not sure, there are subtle differences in symptoms that may give you a clue as to whether it’s a stroke or migraine.

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According to StrokeSmart, here are the questions to ask:

  • Abrupt or gradual? A stroke typically comes on suddenly, without warning. Symptoms are immediately at peak intensity. A migraine aura usually occurs gradually, with symptoms evolving over several minutes and any accompanying headache building to a peak over time.
  • Increased or decreased vision changes? With migraine you see it, with stroke you don’t. Someone having a migraine with aura will experience added visual stimuli, such as flashing lights or zigzagging lines. A stroke, on the other hand, typically diminishes vision — bumping into something may be the first clue that vision has been impaired.
  • Past history of migraine? Although it’s possible to have a first migraine at any age, it’s more typical to begin having them as a child. Most migraine sufferers will also recognize their aura, as it tends to be the same every time. If you have never had a migraine or your migraine symptoms differ from their normal course, get to the closest ER or urgent care center. With stroke, it’s also possible to have one at any age or in any physical shape, so don’t ever rule it out. Call 911 immediately, because it’s better to be safe than sorry.   

For expert emergency care in any situation, one of our many Medical City ER locations across North Texas has you covered. With average wait times posted online, if you do have an emergency, you can spend less time waiting and more time on the moments that matter most.

Find a fast Medical City ER near you or call our free, 24/7 Ask a Nurse hotline.

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