Strokes are the fifth-leading cause of death in the United States, claiming more than 130,000 lives annually, according to the American Stroke Association. Beyond having a high fatality rate, strokes also are the leading cause of long-term disability.
While the risks associated with strokes are alarming, permanent damage can be prevented in many cases when the stroke is identified and treated early. Unfortunately, some stroke symptoms can be confused with other conditions, including migraines, which affect 12 percent of the population, according to the Migraine Research Foundation.
“A migraine headache can cause limb weakness and trouble speaking, which can be confused with a stroke,” said Iyengar Phaniraj, MD, neurologist at Sunrise Hospital and Medical Center.
Understanding the subtle differences in these common ailments can potentially save your life or the life of a loved one.
“A stroke is a blood-flow problem to part of the brain that results in a dysfunction in the area where the blood flow is suddenly cut off,” Phaniraj said. When this occurs, oxygen carried by the blood cannot reach the brain cells, eventually causing the cells to die.
The simple symptoms of a stroke can be remembered using this acronym:
F: face drooping
A arm weakness
S: speech difficulty
T: time to call 911
Other symptoms include:
• Sudden confusion, disorientation and difficulty speaking/understanding speech
• Sudden numbness or weakness, often focused on one side of the body
• Blurred vision in one or both eyes
• Trouble walking, loss of balance or coordination
• Sudden severe headache
The cause of migraines is still unknown, but they’re thought to be a neurological disorder that causes disturbances in the nerve pathways of the brain, which disrupt brain chemicals.
There are many types of migraines with varying symptoms.
• Throbbing/pulsating headache, generally on one side of the head or behind an eye
• Sensitivity to light and sound
• Nausea and vomiting
• Pain on one side of the body
• Vision disruption, blurred vision and/or “aura”
• Disorientation, confusion
• Numbness/tingling in the extremities
• Muscle weakness
• Temporary aphasia (troubled speech)
Understanding the difference
Telling the difference between strokes and migraines often boils down to subtleties in the symptoms, as well as personal/family history.
Migraines often are genetic, and many patients will have multiple migraines throughout their lifetime. Women are overwhelmingly more prone to migraines than men are, and the attacks often occur in connection with their menstrual cycle. Weather conditions, light, smells and exposure to some chemicals may also trigger migraines.
Strokes generally occur suddenly and without warning — the American Stroke Association estimates that about 75 percent of all strokes occur in first-time patients. On the other hand, migraines tend to be much more frequent. Most migraine sufferers will experience an attack once or twice a month, and some people have chronic migraines, experiencing at least 15 monthly.
Other conditions that can cause similar symptoms as a stroke include seizures, hyperglycemia and multiple sclerosis.
Further, transient ischemic attacks (TIAs) are considered ministrokes because they cause temporary blockage of blood flow in the brain. The symptoms of TIAs are similar to those of full-blown strokes, as well as migraines. And while TIAs don’t cause permanent damage, they can be an important warning sign for an upcoming stroke.
If there’s ever any question about the cause of an acute headache, Phaniraj recommends seeing a doctor immediately.
“People cannot and should not attempt to tease the difference if they’re concerned,” he said. “They should get help immediately if any headache appears different than their usual type.”
Timing matters with strokes
After a stroke, rapid medical response is crucial for a positive prognosis.
“By the time a patient shows symptoms, the stroke has already occurred,” Phaniraj said. “The body attempts to improve blood flow to the blocked areas, but that process is not very predictable. The hours after a stroke are a delicate period, and the body needs help to overcome the damage, which is why specialized stroke centers are important.”
The sooner someone seeks help for a stroke, the more brain cells can be salvaged, which limits the amount of permanent damage.
“Every brain cell has a special function, and losing even just one should be avoided,” Phaniraj said. “What Alzheimer’s disease does to the brain in 10 years, a stroke can do in a second.”