I've had chronic daily migraine for over 20 years. They have been bilateral not one-sided, for all this time. Lately I've been experiencing left-sided migraines with numbness and tingling in my extremities. I've had a TIA, mini stroke approximately 10 years ago and wonder if this change in my migraine pattern means I'm more susceptible to having a stroke? Thank You! ~~Pam.
Thank you for your excellent question. Your question raises two important issues:
- what does it mean when migraine patterns change, and
- what is the relationship between migraines and stroke.
First, a change is pattern of migraines, especially one that has been as longstanding as yours has been, can be concerning. Usually it doesn't mean anything more than just that your migraines have changed with time. But as a general rule, if your migraine pattern changes and there is not an easily identifiable reason (i.e. new medication, new medical condition, new stressful life event, etc.) then you should be re-evaluated by your physician and possibly have a workup done to ensure that everything is ok. Just because someone has always had migraines, it doesn't mean that every migraine they have is the same thing. Ask your doctor is he/she thinks you need an MRI or can explain to you why they think you have changed. In your case, with the numbness and tingling and your history of a transient ischemic attack in the past, this is even more important.
In response to the second issue about your risk of stroke, the biggest impact on your overall stroke risk is your previous history of having a TIA. When people are young, having migraine, in particular migraine with aura, does increase the risk of having a stroke. However, at that stage of life, the overall risk of stroke is very low and even with the modest increased risk related to the migraines, the risk remains very low. As you get older or develop other risk factors for stroke (smoking, coronary artery disease, age), the risk associated with having migraine seems to disappear.
To summarize, your new migraines should at least lead you and your provider to consider investigating for a different cause of your new headaches, but there is nothing specific about the migraines you are describing that should increase your risk for stroke.
Thanks for your question,
David Watson, MD, and Teri Robert
About Ask the Clinician:
Dr. David Watson is a UCNS certified migraine and headache specialists and director of the Headache Center at West Virginia University. Je and Lead Health Guide Teri Robert, team up to answer your questions about headaches and Migraines. You can read more about Dr. Watson or more about Teri Robert.
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Published On: August 11, 2014