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Got migraines that cause strokes. MRI and CT scan showed mini stroke damage. Odds of big stroke?

DOCTOR OF THE MONTH - Nov 2013
Nov 2013
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I get severe migraines that cause strokes when the blood vessels constrict. MRI and CT scans show mini-stroke damage. I am on med's to prevent a big stroke. WHY do my blood vessels constrict. Can I prevent this. What are the odds of a BIG stroke. (I am a 45 yr old female. Have had migraines since before I could walk. Sudden weather changes are horrible. Also, hormone cycles are bad. Pregnancy was GREAT - no headaches at all ). Non smoker. Non drinker. No drugs. 5'8" 145 lbs
Posted Thu, 15 Aug 2013 in Brain and Spine
 
 
Answered by Dr. Sudhir Kumar 1 hour later
Hi,

Thank you for posting your query.

First of all, I would like to reassure you that there is very little risk of getting a big stroke in your case.

I agree that people with migraine have a higher risk of getting stroke, however, it generally occurs when there is at least one other risk factor present, such as high blood pressure, smoking and use of oral contraceptive pills.

In your case, you should take preventive migraine medications such as Topiramate, beta blockers, etc to reduce the severity and frequency of migraine attacks. This would ensure that you do not get stroke in future.

I hope it helps. Please get back if you have any more queries.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology) XXXXXXX Consultant Neurologist
Above answer was peer-reviewed by
 
Follow-up: Got migraines that cause strokes. MRI and CT scan showed mini stroke damage. Odds of big stroke? 26 minutes later
I have never taken birth control pills due to the migraine condition.
I was on Inderal la. But my body got "used to it" and I had to keep increasing the doseage. My dr finally took me off it because he felt it was no longer effective.
I am taking topomax, Plavix, and Norvasc.
I would like to know why this constriction happens.
And how to prevent it.
 
 
Answered by Dr. Sudhir Kumar 4 minutes later
Hi,

Thank you for getting back with more details.

I agree with your current medications and with these, the risk of brain stroke can be well prevented.

The exact cause of constriction in migraine is not well known, however, it is believed to be mediated by certain chemicals, which travel via the Trigeminal nerve along the carotid artery and its branches, referred to as trigemino-vascular pathway.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by
 
Follow-up: Got migraines that cause strokes. MRI and CT scan showed mini stroke damage. Odds of big stroke? 1 hour later
The last stroke I had happened in the thalamic region. I have lost my sense of smell and taste.
I have phantom smells that are random and insignificant to the situation.
I get phantom pains
My face (both sides) gets all tingly. As does my scalp. It feels like it has fallen asleep.
During an EEG there was evidence of a seizure, but the dr dismissed it as being a isolated incident.
I have had a brain angiogram.
Carotid ultrasound
EKG
One test showed that the mastoid process was "suspicious". Whatever that means.
Some short term memory loss.
I used to love to knit. But can't anymore.
I would like some explanations, but don't seem to be getting anywhere......
:(
 
 
Answered by Dr. Sudhir Kumar 4 hours later
Thank you for getting back.

Migraine alone usually does not lead to this degree of infarcts (brain strokes) and disability. We need to look for a co-existing disease such as vasculitis and collagen vascular disease, which can cause constriction of arteries and increase the risk of stroke. Brain angiogram (DSA) is usually the gold standard test to diagnose vasculitis. If you can upload that report, it would be useful. Regarding collagen vascular disease, blood tests such as XXXXXXX rheumatoid factor, C reactive protein, XXXXXXX etc would help.

Regarding your symptoms, they would gradually improve over time.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by
 
Follow-up: Got migraines that cause strokes. MRI and CT scan showed mini stroke damage. Odds of big stroke? 42 hours later
Unfortunately, the Canadian medical system has it's flaws. Getting access to records is difficult..... And I'm afraid I'm running out of the time I have paid for here...
I will try. You just need the angiogram report?
The latest stroke I had happened in September. It happened during an orgasm. At the climax, my vision became triple vision, very loud heart beating in my ears, very dizzy and disoriented, my scalp was throbbing and felt like it was on fire, my legs were all twitchy (like athlete legs after a big marathon), and my face had a feeling like it was asleep.
The next 3 days, I had the worst headache of my life, and was still experiencing most of the symptoms. Phantom smells. Phantom tastes. Phantom pains.
The symptoms have improved. But are still present to a certain degree.
My dr has advised me not to do anything that would raise my heart rate.
When I jump rope / skip with my 6 yr old daughter, the symptoms come back.
When I have a hot shower, the same response. But a bath is ok.
Dr also said to try to keep my head above my heart. (leaning over to tie my shoe laces is bad for my brain pressure and symptoms).
I feel like the symptoms are being treated - because they don't know how to treat the disease.
 
 
Answered by Dr. Sudhir Kumar 4 hours later
Hi,

Thank you for getting back.

I agree with you that these measures are like treating symptoms, and not tackling the root cause. These would help you in short term. For successful and long term cure, the underlying root cause should be identified and treated.

Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by
 
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