Both migraines and strokes can cause intense head pain, and the symptoms sometimes overlap. This can make it difficult to know whether you’re experiencing a severe migraine or something more serious.
Understanding the differences between an ischaemic stroke headache and a migraine could help you make the right call when it matters most. In this guide, we’ll break down the key distinctions, what to look out for, and when you should seek emergency help.
What Is an Ischaemic Stroke?
An ischaemic stroke occurs when a blood clot blocks a vessel supplying blood to the brain. This cuts off oxygen to part of the brain, causing cells to die. It’s the most common type of stroke, accounting for around 85 percent of all cases in the UK.
Not everyone who has an ischaemic stroke will experience a headache. In fact, headaches are less common with this type of stroke compared to haemorrhagic strokes, which involve bleeding in the brain. However, when a headache does occur, it can be easy to confuse with other conditions, particularly migraines.
What Is a Migraine?
A migraine is a neurological condition that causes moderate to severe headaches, often accompanied by other symptoms such as nausea, sensitivity to light and sound, and visual disturbances. Migraines can last anywhere from a few hours to several days and tend to recur over time.
Some migraines come with an “aura” – visual symptoms like flashing lights, blind spots, or zigzag patterns that appear before the headache begins. This is where confusion with stroke symptoms can arise, as both conditions can affect vision and cause neurological symptoms.
Key Differences Between an Ischaemic Stroke Headache and a Migraine
While there’s some overlap, several important differences can help you distinguish between the two:
Speed of onset – An ischaemic stroke headache typically comes on suddenly, often within seconds or minutes. A migraine usually builds more gradually, with warning signs like aura or mood changes appearing beforehand.
Type of symptoms – Migraines often cause “positive” neurological symptoms, things that are added to your normal experience, such as flashing lights, shimmering patterns, or tingling sensations that spread slowly across the body.
Strokes tend to cause “negative” symptoms, i.e. things that are taken away. This includes sudden loss of vision, numbness, weakness, or the inability to speak clearly. These symptoms appear abruptly rather than building up over time.
Duration of warning signs – Migraine aura typically lasts between 20 and 60 minutes and usually resolves before or shortly after the headache begins. Stroke symptoms don’t follow this pattern, they persist and may worsen without treatment.
Accompanying symptoms – With a migraine, you might feel nauseous, sensitive to light, or need to lie down in a dark room. With an ischaemic stroke, you’re more likely to experience sudden confusion, difficulty speaking, facial drooping, or weakness on one side of the body.
History of similar episodes – If you’ve had migraines before, you’ll likely recognise the pattern. A stroke headache, on the other hand, often feels completely different from anything you’ve previously experienced.
The FAST Test: When in Doubt, Check
If you’re unsure whether you or someone else is having a stroke, use the FAST test:
- Face – Has one side of the face dropped? Can the person smile evenly?
- Arms – Can they raise both arms and keep them there?
- Speech – Is their speech slurred or garbled?
- Time – If you notice any of these signs, call 999 immediately.
Even if you suspect it might be a migraine, it’s always better to be safe. Medical professionals would rather assess you and rule out a stroke than have you wait at home with a serious condition.
Can Migraines Increase Stroke Risk?
Research suggests that people who experience migraines with aura may have a slightly higher risk of ischaemic stroke, particularly younger women. However, the overall risk remains low for most people.
If you have frequent migraines, it’s worth discussing your cardiovascular health with your GP. Managing risk factors like high blood pressure, smoking, and lack of exercise can help protect you.
Managing Chronic Headaches and Migraines
If you suffer from regular migraines or tension headaches, there are steps you can take to reduce their frequency and severity. Lifestyle factors such as stress, poor posture, and muscle tension in the neck and shoulders are common triggers.
Physiotherapy can help identify physical factors contributing to your headaches. Through targeted exercises and hands-on treatment, a physiotherapist can improve your posture, release muscle tension, and reduce the strain that often leads to head pain.
Manual therapy is particularly effective for headaches originating from the neck and upper back. By improving joint mobility and releasing tight muscles, this treatment can provide significant relief.
Acupuncture is another proven option for headache and migraine management. Using very fine needles, acupuncture can ease muscle tension, promote relaxation, and offer long-lasting pain relief.
At The Green Clinic, we take a holistic approach to treatment. We look at your whole body and lifestyle to understand what’s really causing your discomfort, then create a personalised plan to help you feel better.
Take Control of Your Headaches
If migraines or recurring headaches are affecting your quality of life, you don’t have to simply put up with them. Our experienced team can assess your condition, identify contributing factors, and work with you to find effective solutions.
Book a consultation with The Green Clinic today and take the first step towards fewer headaches and a healthier life.
