Chronic migraine - Risks from pain cycle not being broken?

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  • Full Question:

    I am an Iraqi War Veteran who has been diagnosed through the Veterans Administration to have Chronic Migraine Syndrome.  I have Migraines - with auras- 3-4 times a week depending on if the pain cycle can be broken.  I have gone many times with a severe migraine lasting 2 days to 3 weeks without a break in pain.  I understand that everyone's risk for certain conditions vary person to person but with this type of migraine and pain how high is the risk for stroke?  Is stroke the only major issue that can come from the pain cycle not being broken? Thank you, Erica.


    Full Answer:

    Dear Erica;

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    Thank you for serving. Now, to get to your question:


    We're  not quite following what you mean when you say you have migraines with aura three to four times a week, depending on if the pain cycle can be broken. Are you saying you have three to four migraines a week, or are you saying that you have migraines three to four days a week? The latter would imply migraines lasting more than one day.


    Let's sort one thing out before continuing — migraine disease isn't a pain condition. It's a neurological disease. Migraine attacks vary greatly from one person to the next. For some, the pain is the worst symptom. For others, nausea, vomiting, neck pain, or other symptoms are more severe than the pain. It's not a "pain cycle" that needs to be broken. It's the entire migrainous process going on in the brain that needs to be broken. This is why pain medications aren't the first choice for treating migraines. They can't stop the migrainous process. They can only mask the pain for a few hours during which we hope the migraine ends.


    There is a slight chance of migrainous infarction (stroke) occurring during a migraine with aura. It's described as, "One or more migraine aura symptoms associated with an ischaemic brain lesion in the appropriate territory demonstrated by neuroimaging," by the International Headache Society.


    Migraineurs need to know that having migraine disease increases risk of both stroke and heart attack that could occur at any time, not necessarily during a migraine. These increased risks aren't something that should induce panic, but they are reasons to speak to your doctor about reducing modifiable risk factors for both stroke and heart attack. Here are some articles that address these risks:

    We hope this information is helpful and that you'll follow-up by discussing these risks with your doctor.


    Thanks for your question,
    John Claude Krusz and Teri Robert



    About Ask the Clinician:

    Dr. Krusz is a recognized expert in the fields of headache and  Migraine treatment and pain treatment. Each week, he and Lead Expert Teri Robert, team up to answer your questions about headaches and  Migraines. You can read more about Dr. Krusz or more about Teri Robert.


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    Last updated May 20, 2014.

Published On: May 20, 2014