What percentage of young women with migraine (migraine headaches) experience a cerebrovascular accident (stroke)?

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From the Research

The risk of stroke in young women with migraine is approximately 2-3 times higher than in women without migraine, though the absolute risk remains low, with studies suggesting a 3-4 fold increased risk for those with migraine with aura 1, 2.

Key Findings

  • The increased risk of stroke in young women with migraine is more pronounced in those with additional risk factors such as smoking or use of estrogen-containing contraceptives 3, 2.
  • Migraine with aura is associated with a higher risk of ischemic stroke, with an odds ratio of 6.1 compared to those without migraine or aura 2.
  • The joint effect of combined hormonal contraceptives and migraine with aura is associated with a 6-fold increased risk of ischemic stroke compared to neither risk factor 2.

Recommendations

  • Young women with migraine should be aware of this slightly elevated risk and work with healthcare providers to minimize other stroke risk factors, including:
    • Avoiding smoking
    • Considering non-estrogen contraceptive options if they have migraine with aura
    • Maintaining healthy blood pressure
    • Treating their migraines appropriately

Mechanism

  • The biological mechanism behind this association likely involves vascular dysfunction, inflammation, and hypercoagulability that can occur during migraine attacks, particularly those with aura 4, 1.

Absolute Risk

  • In absolute terms, this translates to roughly 4-8 strokes per 100,000 person-years in young women with migraine compared to 2-3 strokes per 100,000 person-years in those without migraine 1, 2.

References

4
Research

Migraine and risk of stroke.

Journal of neurology, neurosurgery, and psychiatry, 2020

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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