Migraine and Risk of Ischemic Stroke: An Evidence-Based Medicine Review

Stroke is the third leading cause of death and a leading cause of serious long-term disability in the United States [1]. Stroke is also preventable through the management of modifiable stroke risk factors, such as hypertension, smoking, and carotid stenosis [2–5]. Migraine headaches represent a less well-documented potential stroke risk factor [6], and it is unclear how much this risk varies among different migraine sufferers. It is difficult for physicians practicing evidence-based medicine to counsel their patients with migraine because the risk associated with the condition is not well-established. The following review is a summary of the available evidence of stroke risk with migraine, the pitfalls of these studies, and recommendations for assessing and managing stroke risk in patients with migraine.