4 major differences between the two conditions

If you get migraines, then you’re familiar with common signs of an attack, like throbbing on one side of your head. But it’s worth knowing that sometimes a migraine and stroke can have similar symptoms, particularly if you experience migraines with aura, meaning you have sensory changes on top of your headache. About 20 per cent of people with migraines experience aura, which can include issues with your vision, numbness or tingling in your face and arms, and more during a migraine. And while these symptoms could certainly be signs of a migraine attack, it’s important to be sure that you’re not experiencing neurological symptoms related to a stroke, which can include vision problems, numbness, tingling, and a very severe headache. Stroke and migraine are two separate conditions with very different outcomes and treatments, so it’s important for people with migraines to be able to differentiate between the two. Here are four ways to differentiate between a migraine and stroke.

Migraines begin gradually, while strokes happen quickly

Both conditions can cause debilitating headaches, vision disturbances, and sensory changes, so it’s important to pay attention to how quickly these all appear. Typically, migraine headaches come on slowly and become more painful with time, sometimes lasting for several days, whereas a stroke-related headache usually reaches its intensity within a few minutes. Additionally, other migraine symptoms appear in phases too.

You can think of the differences as being similar to turning on a dimmer switch versus turning on a light switch. First, you might notice a small spot in your visual field that makes it difficult to see. Then, you may feel like there are pins and needles in your hands or around your mouth. That feeling can eventually spread to your forearms and face. With a stroke, symptoms usually all occur at the same time. Oftentimes, your symptoms appear suddenly and you may lose sensation in your entire arm and half of your face. On top of that, you may suddenly have trouble seeing clearly and walking.

Changes to your vision will be different depending on what you’re experiencing

In migraines, vision problems are one noticeable aura symptom. You may see a geometric or zigzag pattern in your visual field or flashing lights. But vision changes are notably different during a stroke. Rather than noticing shapes, your environment will suddenly appear dark or blurry. One of the telltale signs of stroke is if a person’s eyes feel like the blinds are being pulled down.

Migraines are more common in people younger than 30; strokes are more common in older people

People of any age can get migraines, but you generally get fewer and less severe attacks once you’re out of your 30s. Strokes most commonly affect people in their 60s, and at this point many individuals who experienced migraines when they were younger generally don’t get them either as frequently or at all anymore. If you can’t tell whether your headache, vision changes, or other symptoms are closer to a stroke or migraine, and you haven’t had a migraine recently, then it’s safest to get emergency care as soon as you can. If you’ve never experienced a migraine and are older than your 30s, your chances of getting your first migraine are low. In that case, it’s safest to get medical care as soon as you can if you’re having symptoms.

That said, younger people can have strokes, particularly individuals with certain medical conditions, like a blood clotting disorder, sickle cell disease, or a metabolic condition.

Migraines are usually set off by a specific trigger, but strokes are not

Not everyone has the same migraine triggers, but stress, hormonal changes, sudden weather changes, and too much or too little sleep can cause a migraine flare-up. Even certain foods or drinks can lead to migraines in certain people. Migraine brains don’t like change, which is why doctors advise people who get migraines to follow a consistent schedule as best as they can.

Unlike migraines, strokes aren’t triggered by a specific change, though there are risk factors that can increase your chances of developing a stroke, including high blood pressure, heart disease, diabetes, and history of mini-strokes. If you’re not at risk of a stroke, your symptoms occur after encountering one of your specific migraine triggers, and they are similar to symptoms during previous migraines, then migraine may be the cause of your pain.