Migraine or stroke? How to tell the difference
If you or a loved one suffers from migraine, you’re not alone — this neurological disease affects one in four U.S. households.
Each June, Migraine & Headache Awareness Month highlights the third most common disease worldwide, a time to increase education and highlight the impact migraines have on daily life. It’s also an opportunity to clear up a common misconception: migraine is not a stroke, though some symptoms can overlap.
“The symptoms of migraine and stroke occasionally overlap, meaning the two can sometimes get confused,” says Keith DeSousa, MD, an interventional neurologist with HCA Florida Healthcare and the director of neuroscience at HCA Florida Blake Hospital in Bradenton, Florida.
Dr. DeSousa helps explain the differences between migraine and stroke, including warning signs to watch for, how symptoms can sometimes mislead, and why knowing the distinction is critical.
A closer look at migraine
Migraine is more than just a bad headache — generally it is throbbing or pulsing, and patients frequently experience varied accompanying symptoms
Beyond moderate to severe head pain, migraine symptoms can also include:
- Brain fog
- Difficulty sleeping
- Dizziness
- Mood changes
- Nausea
- Sensitivity to light and sound
Around 20% of people with migraine also experience aura — neurological symptoms like visual, sensory, or motor disturbances that occur just before a migraine episode. Often considered a warning stage, migraine aura typically lasts about an hour and may cause visual disruptions (such as seeing spots or sparks) or even affect speech clarity.
A closer look at stroke
Stroke is a medical emergency that occurs when blood flow to the brain is interrupted. It’s a leading cause of death in the U.S. and a major contributor to serious disability in adults. Some risk factors for stroke include high blood pressure (hypertension), smoking and obesity.
There are two types of strokes:
- Ischemic, which develops when blood flow to the brain is blocked
- Hemorrhagic, which develops when there is sudden bleeding in the brain
Dr. DeSousa also points to the “BE FAST” acronym to remember what’s important to notice when it comes to signs of stroke:
- Balance trouble or Bad headache
- Eyes (vision difficulties)
- Face weakness
- Arm weakness
- Slurred speech
- Time to call 911
When in doubt, get it checked out
Though migraine and stroke occasionally share some similar symptoms, Dr. DeSousa says there are differences to pay attention to — namely, those related to the severity of symptoms, how quickly they develop and whether they persist.
“If you’ve never had a headache before and suddenly develop a severe headache, it’s best to go in and get it checked out,” he says. “If you have a history of headaches and it comes on gradually, with pounding on one side, it’s more likely to be a migraine.”
Dr. DeSousa stresses that it’s always better to err on the side of caution, especially if you have a severe headache with any “BE FAST” symptoms, or symptoms like nausea, vomiting and neck stiffness.
“If you’re not sure if what you’re experiencing is a migraine or a stroke, the only way to rule out a stroke is going to the hospital quickly to be evaluated. A few years ago, stroke was basically untreatable. With new medication and technology, certain types of stroke can essentially be reversed if treated quickly.”
Recognizing the signs and acting fast can be life-saving. Knowing where to turn for care makes all the difference.
When seconds count, don’t wait
Because signs and symptoms of a stroke can appear suddenly and without warning, HCA Florida Healthcare offers comprehensive stroke centers with emergency stroke care teams available around the clock to provide diagnosis and treatment.
“Treatments for stroke are time-limited, so it’s important to seek care quickly,” Dr. DeSousa says.
If your headache comes on gradually but you’re still concerned, help is just a call away. Our experienced, licensed nurses are available 24/7 — free of charge — to guide you on the next steps for care.
Call HCA Florida Healthcare’s Consult-A-Nurse® line at (844) 70-NURSE for expert guidance when you need it.