A lot is known about migraines; however, some key details about these recurring headaches remain hiding in the dark — much like those who suffer. For instance, research has indicated migraine with aura might be a risk factor for stroke, yet none of the studies have been extensive enough to verify this link. Now, a new study of the matter has found that older people with a history of migraine headaches have double the odds of ischemic brain infarction, sometimes referred to as a silent stroke, compared to people without migraines.

“We still don’t know if treatment for migraines will have an impact on stroke risk reduction, but it may be a good idea to seek treatment from a migraine specialist if your headaches are out of control,” said Dr. Teshamae Monteith, lead author of the study and assistant professor of clinical neurology and chief of the Headache Division at the University of Miami Miller School of Medicine.

The sad facts about migraines are they affect three times the number of women compared to men, and nearly 90 percent of sufferers have a family history of these headaches. Another detail to consider: Though a first attack can occur at any age, most people will have had that awful experience by age 40. In fact, these recurring headaches, which may last anywhere from four hours to three days, commonly begin during adolescence. While most people experience migraine headaches without aura, some sufferers experience, in some cases for up to an hour, nervous system symptoms that might include visual phenomena, such as seeing bright spots, shapes, or flashes of light; vision loss; prickly sensations in an arm or leg; or speech or language problems.

The symptoms of migraine with aura, then, are both powerful and intense, and for this reason many researchers have already explored whether they may cause actual brain damage; yet until now any evidence of a possible link between migraine and cerebrovascular disease has been demonstrated in limited, predominantly white population studies. A team of researchers led by Monteith hypothesized that the link between migraine and white matter hyperintensity volume and silent brain infarction might be better explored if they examined data from the Northern Manhattan Study (NOMAS), a racially/ethnically diverse population-based urban cohort funded by the National Institute of Neurological Disorders and Stroke. This study follows 3,289 participants to understand rates of stroke, possible risk factors, and prognosis.

To begin their subset migraine study, the researchers compared magnetic resonance imaging (MRI) results from 104 people with a history of the headaches and 442 without. They discovered older people with migraines had double the number of silent brain infarctions. Yet, they also found it wasn’t necessary that a patient suffer migraines with aura for this link to cerebral damage to exist. Surprisingly, they also discovered that migraine patients showed no increase in small blood vessel abnormalities (white-matter hyperintensities) when compared to people without headaches, which is the very opposite of what various past studies have shown.

The researchers question whether preventive treatment to reduce the severity and number of migraines might reduce the risk of stroke and silent cerebral infarction. “I do not believe migraine sufferers should worry, as the risk of ischemic stroke in people with migraine is considered small,” Monteith stated in a press release. “However, those with migraine and vascular risk factors may want to pay even greater attention to lifestyle changes that can reduce stroke risk, such as exercising and eating a low-fat diet with plenty of fruits and vegetables.”

Source: Monteith T, Gardener H, Rundek T, et al. Migraine, White Matter Hyperintensities, and Subclinical Brain Infarction in a Diverse Community: The Northern Manhattan Study. Stroke. 2014.