Headache Before Stroke More Common in Migraineurs

by Teri Robert, Lead Expert

"Headache is a common clinical symptom preceding or accompanying stroke, and migraine patients have a greater probability of complaining of headache, often with migraine-like features, before and during acute stroke than non-migraineur patients... The more frequent involvement of brainstem in migraineur patients with ischemic infarction supports the hypothesis that vascular events preceding the clinical stroke...can cause a dysfunction of this structure, which may be more predisposed to be abnormally activated."2

Dr. Paola Sarchielli, Lead Researcher

Italian study results just released demonstrate that Migraineurs are more likely to experience a headache before the onset of a stroke than patients without Migraine disease.

Study Methods

In this case-control study*, 96 acute stroke patients with a lifetime history of migraine (M+) and 96 stroke patients without (M-) were selected and headache attributed to acute ischemic stroke (stroke cause by blocked blood vessel) was analyzed.

Study Results

  • In the M+ group, a higher prevalence of headache preceding stroke than in the M- group.
  • In the M+ group, the headache preceding stroke more often had Migraine features.
  • In the M- group, headache rarely occurred. This headache, when it occurred, was usually accompanied by other neurological signs of stroke and more frequently had the features of tension-type headache.
  • M+ participants experienced more strokes in the brainstem than M- participants/
  • 66% of participants with stroke located in the brainstem experienced headaches with Migraine features before the onset of stroke.
  • Although the researchers expected to find a higher incidence of stroke in the M+ group than the M- group, they did not. They state that this may be because they had more M+ patients who had Migraine with aura (MwA) patients than Migraine without aura (MwoA) and MwA has been shown to be associated with increased risk of stroke during and outside of Migraine attacks.

The researchers note a disadvantage of the study:

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