Migraines Associated With Increased Risk of Silent Stroke

MedicalResearch Interview with:
Dr. Teshamae Monteith MD
Assistant professor of Neurology
Chief of the Headache Division
University of Miami Miller School of Medicine.

MedicalResearch: What are the main findings of the study?
Dr. Monteith:   

  • A doubling of silent brain infarctions in those with migraine even after adjusting for other stroke risk factors;
  • No increase in the volume of white-matter hyperintensities (small blood vessel abnormalities) that have been associated with migraine in other studies;
  • Migraines with aura — changes in vision or other senses preceding the headache — wasn’t common in participants and wasn’t necessary for the association with silent cerebral infarctions.
  • High blood pressure, another important stroke risk factor, was more common in those with migraine. But the association between migraine and silent brain infarction was also found in participants with normal blood pressure.

MedicalResearch: Were any of the findings unexpected?

Dr. Monteith:  We did not expect to find an association in risk of silent brain injury in patients without migraine aura.  However, we suspected there would be an important association between silent brain infarction and migraine in the predominately Hispanic cohort, for which stroke disparities exists.

MedicalResearch: What should clinicians and patients take away from your report? 

Dr. Monteith:   Migraine is a risk factor for stroke.  While the effect of migraine treatments on stroke outcomes is unknown, migraine patients with vascular risk factors should be counseled for stroke risk factor modification based on the AHA/ASA guidelines.    The research raises the question of whether preventive treatment to reduce the severity and number of migraines could reduce the risk of stroke or silent cerebral infarction.

MedicalResearch: What recommendations do you have for future research as a result of this study?

Dr. Monteith:   While the lesions appeared to be ischemic, based on their radiographic description, further research is needed to confirm our findings.


Monteith T, et al “Migraine, white matter hyperintensities, and subclinical brain infarction in a diverse community: the Northern Manhattan Study” Stroke 2014; 10.1161/STROKEAHA.114.005447.


Last Updated on May 15, 2014 by Marie Benz MD FAAD