4 Major Differences Between Strokes and Migraines

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 percent 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, according to the Mayo Clinic. 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, according to the Centers for Disease Control and Prevention. 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.

First, let’s talk about the causes of each condition: While it’s not clear what causes migraine headaches, they generally lead to throbbing or pulsing in your head that can last anywhere from hours to days, according to the Mayo Clinic. As for strokes, although there are various types, they all result in the brain being starved of the blood and nutrients it needs to function properly. And with strokes, it’s important to get to the hospital as quickly as you can to preserve brain tissue. (Migraines can generally be treated at home by going into a dark room and using pain medications, according to the Mayo Clinic—though severe or frequent migraines may benefit from longer-term maintenance medication.) Hopefully, you won’t be affected by a stroke, but understanding the nuances between the two conditions can help you seek the appropriate care if you’re ever confused about which one you’re experiencing. Here are four ways to differentiate between a migraine and stroke.

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1. 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, according to Carrie Oakley Dougherty, M.D., associate professor of neurology at Georgetown University Medical Center. “In the situation of migraine with aura, it’s generally a progression of symptoms over time,” she tells SELF.

You can think of the differences as being similar to turning on a dimmer switch versus turning on a light switch, she explains. First, you might notice a small spot in your visual field that makes it difficult to see, Dr. Dougherty says. 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, Dr. Dougherty explains. “With a stroke, symptoms usually all occur at the same time,” Dr. Dougherty says. Oftentimes, your symptoms appear suddenly and you may lose sensation in your entire arm and half of your face, she says. On top of that, you may suddenly have trouble seeing clearly and walking, according to the Mayo Clinic. If you experience an onslaught of these symptoms, then it’s really important to head to the hospital as fast as possible so a doctor can evaluate your condition and provide treatment.

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

In migraines, vision problems are one noticeable aura symptom, according to the University of Michigan. You may see a geometric or zigzag pattern in your visual field or flashing lights, according to Dr. Dougherty. But vision changes are notably different during a stroke. Rather than noticing shapes, your environment will suddenly appear dark or blurry, according to Phil Stieg, Ph.D., M.D., a neurosurgeon and founder of the Weill Cornell Medicine Brain and Spine Center. One of the telltale signs of stroke is if a person’s “eyes feel like the blinds are being pulled down,” Dr. Stieg tells SELF.

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