Yesanto Domingo.-Migraine is much more than an intense headache, warns Vifranny Espaillat Durán, neurologist and subspecialist in vascular neurology at Cedimat, who highlights that current scientific evidence confirms a significant relationship between migraine and cerebrovascular accident (CVA), especially ischemic stroke, in certain groups of patients.
For years, migraine was considered a painful but benign disorder. However, recent research has shown that people who suffer from it, particularly those who have migraine with aura, are at increased risk of suffering a cerebrovascular event, especially women and young adults.
Highly prevalent
According to epidemiological data, migraine affects approximately 15% of the world’s population and is one of the main causes of neurological disability in people of productive age. Its prevalence is notably higher in women, with a proportion close to three women for every affected man.
Generally, migraine begins in adolescence or early adulthood and can persist for decades, considerably impacting the quality of personal, family and work life.
Espaillat explains that the most recent population studies and meta-analyses confirm that people with migraine have a higher risk of stroke compared to those who do not suffer from this condition.
This risk is mainly concentrated in migraine with aura, characterized by transient neurological symptoms such as visual, sensory or language alterations.
In women with migraine with aura, the relative risk of stroke can double compared to women without migraine. Although the absolute risk remains low, its clinical relevance increases when it is associated with other predisposing factors.
Migraine increases risk
The relationship between migraine and stroke is complex and multifactorial. Among the proposed mechanisms are alterations in the regulation of cerebral blood flow, dysfunction of the vascular endothelium, changes in platelet function and coagulation, as well as shared genetic factors.
Furthermore, the risk of stroke increases significantly when migraine coexists with smoking, high blood pressure, dyslipidemia, a sedentary lifestyle or obesity. For women, the use of hormonal contraceptives may further increase this risk.
The doctor highlighted that one of the main clinical challenges is to differentiate a migraine attack from a stroke in its initial phases, which is crucial, since stroke treatment is highly time-dependent.
Among the warning symptoms of a stroke are sudden weakness or numbness of the face, arm or leg, sudden difficulty speaking or understanding language, and others.
“The presence of these symptoms should not be automatically attributed to a migraine,” emphasized neurologist Espaillat.
Causes of consultations
— Migraine
It is one of the most frequent reasons for consultations, followed by headache disorders, stroke and its sequelae, memory and cognitive function disorders, dizziness, vertigo and sleep.
