. . . more people died from Migrainous Stroke last year than were murdered by handguns.1
Unfortunately, those who suffer with Migraine disease or other headache disorders are all too used to not being taken seriously. A doctor recently said to one of our forum members that, "Migraine isn't really a health issue as much as a quality of life issue." Were it within my power, I'd revoke his license to practice medicine -- after I slapped him silly, of course. Is it any wonder that Migraineurs often don't realize the possibly serious ramifications of Migraine attacks when their doctors make such uneducated comments?
Abi S. was young woman who was a participant in a forum and chat room I moderated was in the throes of a multi-day Migraine attack. Her medications hadn't helped, and she had not sought emergency care because her parents had accused her of faking Migraines to get attention. A few days later, I received an email from her mother telling me that on the seventh day of her Migraine, the young woman began having seizures, and was in a coma. Tests indicate that she has had a stroke. She came out of the coma, recovered, and was discharged from the hospital. A few weeks later, she had another Migraine, suffered another Migrainous stroke, and died. She was just days from her 22nd birthday.
Migraine and the degree to which it increases risk of stroke is a topic on which expert opinions vary. There is, however, agreement that Migraine does increase the risk, and that status migrainous increases the risk even further.
According to the International Headache Society criteria, when a debilitating Migraine attack lasts more than 72 hours, whether it is treated or not, it is termed "status migrainousus:"
- head pain may be continuous through the attack or interrupted by headache-free periods of less than four hours
- relief while sleeping is disregarded
- short-lasting relief from medications is also disregarded
"Patients with status migrainousus need aggressive treatment ... The principles of treatment for status migrainousus include the following:
- fluid and electrolyte replacement
- drug detoxification if medication overuse is present
- IV pharmacotherapy to abort the Migraine
- treatment of associated symptoms of nausea and vomiting
- concurrent implementation of Migraine prophylaxis (if indicated). . .
- After acute treatment is completed, many patients with status migrainousus require continuing care. . ."2