If you're an older adult who suffers from migraines, you may also have a symptomless type of brain injury that puts you at increased risk of a stroke. These findings come from a study recently published in the American Heart Association's journal, Stroke.

The Link Between Migraines and Stroke

While the link between migraines and stroke in younger people has been identified in previous studies, not much attention has been paid to the connection in older folks. This prompted the National Institute of Neurological Diseases and Stroke to fund the Northern Manhattan Study (NOMAS), which is a joint effort between researchers at New York’s Columbia University and the University of Miami.

The scientists looked at the brain imaging results of a group of senior citizens who came from different ethnic groups. What they discovered is that the older participants with a history of migraines had double the rate of a form of brain injury called "silent brain infarctions" than people without migraines. In layman's terms, silent brain infarctions are a type of vascular (blood vessel) brain injury—or symptomless stroke—that occurs when a blood clot cuts off oxygen supply to the brain tissue. Although this form of brain injury doesn't have any obvious signs, doctors believe its presence increases the likelihood of having more serious strokes.

An Important Finding

This is an important finding that, until now, seems to have been overlooked, according to lead researcher Teshamae Monteith, MD, Chief, Headache Division and Assistant Professor of Clinical Neurology at University of Miami’s Miller School of Medicine.

"It's my impression that migraine is not often considered when older patients have strokes," Monteith says. "Clinicians are more likely to ask about diabetes, high cholesterol, and high blood pressure," she adds. While these are all indeed important risk factors, she says that the study findings can serve as a reminder about the need to also better understand the relationship between migraine, vascular risk factors, and stroke.

What This Means for You

Monteith stresses that more research is needed to better understand these associations before formal clinical recommendations can be made for migraine sufferers, since their likelihood of experiencing a significant stroke from a silent brain injury is still quite small. Therefore, undergoing testing to identify such silent brain damage is not recommended at this time.

"However, primary stroke and cardiovascular risk factor prevention is wise," Monteith says. This means following the latest heart health and stroke prevention guidelines. These include:

  • Eating a heart-healthy, low-fat diet that's high in fruit and vegetables.
  • Reducing sodium (salt) intake.
  • Maintaining a healthy weight.
  • Engaging in regular exercise.
  • Keeping cholesterol within healthy levels.

Monteith also says that people who get migraines regularly should see their doctor to try to get the problem better controlled. For more information about heart health and stroke prevention, you can also visit the American Heart Association's website at heart.org.

Teshamae Monteith, MD, University of Miami, Miller School of Medicine, reviewed this article. 


"Older Migraine Sufferers May Have More Silent Brain Injury." American Heart Association. Accessed online, May 15, 2014. 

Teshamae Monteith, MD, Chief, Headache Division, Assistant Professor of Clinical Neurology, University of Miami, Miller School of Medicine. Email interview July 14, 2014. 

Teshamae Monteith, MD, et al. "Migraine, White Matter Hyperintensities, and Subclinical Brain Infarction in a Diverse Community: The Northern Manhattan Study." Stroke 45 (2014): 1830-1832. (Published online before print May 15, 2014.) doi: 10.1161 Accessed online July 14, 2014.