Do Migraine Headaches Increase Your Stroke Risk?

woman sitting at table with headache
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Younger women who suffer from migraine headaches — especially migraine with aura — do have an increased risk of stroke when compared with women who haven't been diagnosed with migraine disorder.

But don't let this worry you too much, even if you fall into the affected age group — your overall risk of stroke remains low.

Researchers long have been interested in the potential relationship between migraine disorder and stroke.

Studies released in the last decade have identified the one type of stroke that's associated with migraine and have quantified the overall increase in risk in women. Men do not appear to have an increased risk of stroke associated with migraine.

Migraine Associated with Ischaemic Stroke

There are two types of stroke: ischemic stroke, which occurs when an obstruction blocks a blood vessel in the brain, and hemorrhagic stroke, in which a blood vessel in the brain ruptures. Ischemic stroke accounts for the vast majority of all cases of stroke, and it's also the form of stroke that's associated with migraine disorder.

Specifically, women younger than 45 who suffer from migraine with aura have a risk of ischaemic stroke that's more than twice as high as the average risk for their age group. Women younger than 45 who have migraine without aura also are at a slightly increased risk for ischaemic stroke.

If you smoke and/or use oral contraceptives and you get migraine headaches with aura, your risk is higher still.

However, to put these figures into perspective, stroke is rare in younger people: it affects only about one in 1,000 people younger than age 45. More than three-quarters of all strokes affect those over age 65.

So even if you're a young woman who has migraine with aura, plus you smoke and use oral contraceptives, your risk of stroke still remains low overall, even if that risk is much higher than the risk faced by your peer group.

Once you reach age 55, factors such as high blood pressure and obesity take precedence as risk factors for stroke, and your history of migraine stops mattering.

Why the Increase in Risk for Younger Women?

It's not clear why only younger women — not men or older women — face this increased risk of stroke.

It's possible that both stroke and migraine in this group are associated with risk factors for cardiovascular disease, and possibly also with a higher tendency to form blood clots. Researchers also are considering vascular differences as a possible cause or risk factor. However, they haven't yet pinpointed a mechanism that explains the increased risk in this one particular group.

As I said, the overall risk for stroke remains very low, even if you're a younger woman and have migraine with aura.

However, you may be able to reduce your risk even further.

You definitely should avoid smoking or quit if you already smoke. You also should talk to your doctor about alternative forms of birth control. Your doctor may recommend a non-hormonal form of birth control, or she may recommend oral contraceptives with very low levels of hormones (lower levels are better in terms of stroke risk).

Finally, you should familiarize yourself with the symptoms of a stroke. When stroke hits a younger person, clinicians may mistake it for something else, including a bad migraine. Since quick treatment is critical to avoid permanent damage, it's important that you recognize a stroke as fast as possible.


Etminan M et al. Risk of ischaemic stroke in people with migraine: systematic review and meta-analysis of observational studies. BMJ. Jan 8;330(7482):63.

Harriott AM et al. Dissecting the association between migraine and stroke. Current Neurology and Neuroscience Reports. 2015 Mar;15(3):5.

Lantz M et al. Prevalence of migraine headache in an in-patient stroke population. Acta Neurologica Scandinavica. 2015 May;131(5):290-7.

The Migraine Trust. Stroke and Migraine fact sheet. Accessed Nov. 30, 2015.

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