Migraine Monsters Hiding in the Closet

Patient Expert & Health Professional
Medically Reviewed
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Fears that Migraine will lead to or contribute to more serious health problems are common. Headlines claiming links between Migraine and deadly diseases can keep us awake at night. In most cases, those headlines don’t tell the whole truth. Fortunately, the antidote to fear is truth. It’s human nature to fear what we don’t understand. Once we learn the truth, fear is often eliminated or greatly reduced.

Migraine “monsters” hiding in the closet

  • White matter lesions
  • Brain tumor
  • Stroke
  • Heart attack
  • Parkinson’s
  • Cognitive decline

Let’s turn on the lights and discover the truth. For starters, remember that most of these “monsters” apply only to those who have Migraine with aura. The prevalence of Migraine with aura is 25 to 30 percent. That’s good news for the 60 to 75 percent of patients who never experience aura. For those who do experience aura, there’s still good news.

Association is not causation

In almost every case, these “monsters” have been shown only to have an association with Migraine. That means that they are comorbidities and not caused by Migraine. There is no reason to fear that Migraine itself will cause most of these.

White matter lesions are the exception

White matter lesions do appear to be caused by Migraine. They are present in 63.4 percent of Migraine patients, with and without aura. However, there is a correlation between the duration of aura and the number of white matter lesions. At this point, there have been no reports of symptoms resulting from these lesions.

Some patients have reported that their MRI reports have noted these lesions and suggested a possible diagnosis of multiple sclerosis (MS). While alarming, Migraine specialists are trained to distinguish the benign white matter lesions from those present in MS.

Brain tumor

This is also one of the least likely of the “monsters” to truly be a threat. The March 2015 issue of Headache published a study concluding that brain tumor is not a long-term consequence of Migraine. Additionally, the study noted that the headache symptoms of a brain tumor are not consistent with the symptoms associated with Migraine. In most cases, Migraine doctors will order an MRI to rule out other problems prior to diagnosing Migraine.

Stroke

There’s plenty of evidence that Migraine with aura increases stroke risk. A January 2017 study published in BMJ also concluded that people with Migraine are at increased risk of peri-operative stroke.

That may sound alarming until you understand that the actual risks are:

  • 2.4 per 1,000 in the general population
  • 3.9 per 1,000 in Migraine without aura
  • 6.3 per 1,000 in Migraine with aura

If you have Migraine with aura, it also makes sense to talk to your doctors about minimizing risk factors, for stroke, which include:

  • High blood pressure
  • High cholesterol
  • Oral contraception
  • Cigarette smoking
  • High sodium intake

It also makes sense to inform your surgeon and anesthesiologist that you have Migraine prior to an operation so they can take necessary precautions during surgery to reduce any risks.

Heart attack

People with Migraine with aura are 2.08 times more likely to have a heart attack than the general population. No increased risk has been demonstrated in people with Migraine without aura. The general agreement among Migraine experts is that Migraine with aura and cardiovascular disease may share a genetic link.

If you have Migraine with aura, it’s a good idea to talk to your doctors about minimizing your risk factors for heart attack. These include:

  • High blood pressure
  • High cholesterol
  • Oral contraception
  • Cigarette smoking
  • High sodium intake
  • Inactivity
  • Diabetes
  • Obesity

Parkinson’s

According to a study published in the September 2014 issue of Neurology, the presence of Migraine with aura in midlife is associated with a 2.4 percent risk of developing Parkinson’s in late life, compared with a 1.1 percent risk in the general population. Possible reasons for the association may include other shared factors:

  • Dopamine dysfunction is present in both.
  • Restless leg syndrome is comorbid to both.
  • Head injury is a known risk factor for both.
  • Stroke is associated with Migraine and is a risk factor for Parkinson’s.

Many of the risk factors for Parkinson’s are non-modifiable. Still, it is important to recognize the true risks for the sake of being informed, rather than fearful. Keep in mind that, at most, the relative risk is 2.4 percent. It’s not as if a large percentage of people with Migraine are guaranteed to develop Parkinson’s.

Here are the major risk factors for Parkinson's:

  • Migraine with aura present in mid-life
  • History of restless leg syndrome
  • Family history of Parkinson’s
  • Being over age 60
  • Being male

Even if you are at risk, there are steps you can take to lower it:

Cognitive decline

Many people with Migraine express concerns about memory loss, inability to concentrate, other cognitive impairments, or that Migraine will cause permanent damage to their cognitive abilities. It should come as a relief that, according to a 2013 literature review in Headache, people with Migraine of any type are not at increased risk for cognitive decline. You may experience temporary, reversible cognitive impairment during attacks and as a side effect of some commonly prescribed medications. Address any concerns about your cognitive abilities with your doctors.

See more helpful articles:

Migraines and White Matter Lesions: What We Should Know

Stroke: The Basics

Migraine Linked to Higher Perioperative Stroke Risk

Migraine With Aura Linked to Cardiovascular Disease in Women

Study Links Migraine and Parkinson’s

Hemiplegic Migraine May Cause Brain Damage