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Migraine changes your brain in many of the same ways as stroke, and not just when you have a headache.

I had migraines nearly every day for about 30 years.

While I did have a headache, like most male migraineurs my symptoms were primarily sensory and verbal. I would see stars, like I had been punched in the face. Often I would have a blind spot that would expand across my field of vision, fuzzy lines that weren't total darkness but that didn't make any visual sense. I would feel dizzy and nauseous. And I'd become extremely tongue-tied. "I am having a migraine" might become "Itchy head migraine ouch," or something in another language entirely.

My experience with migraine is anything but unique. More and more researchers are realizing that migraine isn't a painful headache caused by expansion of blood vessels in the head. Migraine is primarily a neurological condition that can compared to a "very slow stroke." If you have migraines nearly every day, as I did for years, they cease to cause anxiety, but if they are an occasional event for you, then the painful headache can also become the prelude to a generalized anxiety attack that can be every bit as disabling as the migraine itself.

Migraine Is a Much More Serious Condition Than Most People Know

In 1967 the late neuroscientist Oliver Sacks wrote a book entitled Migraine In which he speculated that migraine had many of the same effects on the brain as stroke, only without a blood clot, and over a much longer period of time.

Physical evidence for his theory was scarce until 2004, when another neuroscientist named Mark Kruit at from Leiden University Medical Center in the Netherlands and his colleagues gave MRIs to 300 migraine patients and 300 healthy controls. These brain scans revealed that the MRIs of people who have migraines were much more likely to have bright spots in the white matter of the cerebellum. These spots were found in the part of the brain that insulates neurons so that they don't generate "stray sparks" that would interfere with the passage of electrical signals from the back of the brain to the cerebral cortex. And in about 8 percent of the volunteers who had migraines, Kreut and colleagues found evidence of stroke-like damage to the brain. These lesions were more common in migraine sufferers who experience auras, the kaleidoscopic shapes and colors or the zig-zag shading of central vision before headache pain starts.

Stroke-Like Damage

The main reason that neuroscientists refer to brain damage in migraine as "stroke like" is that it is known that blood circulation to the parts of the brain affected by migraine first increases and then decreases, as it would in a stroke. That's where the similarity to stroke ends. People who have this kind of damage don't develop paralysis or loss of speech as they might in stroke. They don't signal future development of Alzheimer's or dementia. The number of spots tends to increase over time in women who have migraines, but not in men. However, stroke-like lesions are not the only brain changes that occur with chronic migraine.

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  • Koppen H, Boele HJ, Palm-Meinders IH, Koutstaal BJ, Horlings CG, Koekkoek BK, van der Geest J, Smit AE, van Buchem MA, Launer LJ, Terwindt GM, Bloem BR, Kruit MC, Ferrari MD, De Zeeuw CI. Cerebellar function and ischemic brain lesions in migraine patients from the general population. Cephalalgia. 2016 Apr 7. pii: 0333102416643527. [Epub ahead of print] PMID: 27059879.
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