Two main types of stroke occur. One is when a blood vessel to the brain bleeds (a cerebral hemorrhage), the other when a blood vessel is blocked (a cerebral infarction). Cerebral hemorrhage patients almost always suffer from headache, especially if blood enters the area surrounding the brain, displacing pain-sensitive blood vessels. The pain is sudden, severe and persistent.
While the severity of migraine attacks often causes patients to fear they are having a stroke the likelihood of a migraine attack causing a stroke is very remote. That is not to say that migraine sufferers cannot have a stroke associated with their migraines. In persons under age 40 the most common associated factor for stroke is migraine headache.
Long-term migraine without treatment has been shown to predispose sufferers to increased effect on the blood vessels of the brain, especially in those with signs of migraine with aura (classical migraine). Persons who have visual or neurological symptoms accompanying their migraine attacks should avoid other risk factors such as smoking, high cholesterol diets, the use of estrogen and untreated hypertension. These risk factors for cerebral vascular disease, if present in a setting of migraine, may greatly increase the risk of one having a migraine-related stroke.