Are Migraine Auras Dangerous?

The Aura Kills More People Than The Migraine Will...

The Short Answer –

Are migraine auras dangerous? Absolutely. Migraine auras are potentially the most dangerous element of any migraine with aura. The aura itself can both restrict blood to the brain, mimic that of a TIA or cause serious risk to your health due to the loss of cognitive ability.

Why Your Aura Is Important…

In previous articles we have looked at the causes, triggers and treatments for migraines with aura. We analysed how latest theories believe that the auras before a migraine are caused by what is known as ‘cortical spreading depression’.

I explained that this cortical spreading depression was effectively a wave of ‘electrical silence’ moving through your brain and that when this silence passed through your visual cortex, that was when the visual disturbances that we know as an aura take place.

Typical visual aura symptoms include –

  • Blind spots
  • ‘Seeing stars’
  • Flashing lights
  • Tunnel vision
  • Confusion
  • ‘Tears’ across your vision
  • Temporary blindness
  • Sudden nausea or sickness
  • Feelings of separation from your body

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Are Migraine Auras Dangerous – Absolutely (And Very Serious)…

But unfortunately, it’s not as simple as that. Besides a sudden drop in brain waves, CSD (cortical spreading depression) also results in a drop in blood flow to the brain.

As you might expect, a reduced blood flow in the brain can have consequences beyond that of ‘just’ the visual disturbances. We can split the reasons why visual auras are so dangerous down into 3 parts –

  • Ischaemic Stroke
  • TIA
  • Cognitive Loss

Ischaemic Stroke

There is plenty of evidence that migraines with aura leave behind small non specific white lesions on the brain. This has been seen through numerous scans and is not common in people who still suffer migraines, but without the aura

These lesions effectively lead to damage, or even death, of brain tissue. Because the aura causes the reduced blood flow that leads to brain cell damage, it is called an ‘ischaemic stroke’.

 

It has been statistically proven that people who suffer auras before their migraine (or on its own without a migraine headache), are more likely to go on and suffer a stroke.

TIA

A TIA or Transient Ischemic Attack is like a mini stroke. Even more seriously, it is often comes just before a full stroke (The Lancet

One of the biggest dangers with suffering an aura is actually when they NOT an aura at all. For a whole variety of reasons, aura sufferers have been known to actually dismiss a TIA as another aura – when it’s actual fact they should be seeking urgent medical care as a major stroke could be on it’s way.

The 2nd big danger with aura’s then is the risk that a TIA is ignored because it’s symptoms are very similar to that of an aura. (Stroke Journal)

Cognitive Loss

Imagine driving home and suddenly your vision starts to fade, along with a sense of confusion and a feeling that you are moving ‘out of your body’.

The car you are driving is a lethal weapon and any accident could kill you and others.

But that’s just one example.

Auras can strike without warning and render the recipient in varying states of loss.

Operating machinery, going for a swim, even doing shopping in the local supermarket could be dangerous if you suddenly start to lose your cognitive function.

It is after all, not unusual for sufferers to suddenly lose all sense of where they are or what they are doing. At best, they may just find that their eyesight is suddenly substantially impaired.

Sufferers have to make it to a safe place and quickly, to alleviate some of the risk, but the cognitive loss can be both very confusing and increase stress, which in turns often triggers a migraine to follow.

The Final Word –

There are 3 key ways in which a migraine aura is dangerous – the brain damage from a lack of blood flow to the brain, the risk of actually suffering a TIA but confusing it with an aura and the physical effects on your cognitive performance in the first place.

All three of these arguably make the aura far more dangerous than any migraine that follows. This is because although migraine can be extremely painful and debilitating, they are generally not fatal.

Strokes, brain damage or sudden unplanned blindness and confusion, can however be exactly that – extremely dangerous.

Are migraine auras dangerous? Without doubt, yes.

Thankfully, with a good treatment plan, migraine auras are ‘fully reversible’ (The International Classification of Headache Disorders 3rd edition). https://ichd-3.org/

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References Used –

1. Dr S Claiborne Johnston MD, Peter M Rothwell MD, Mai N Nguyen-Huynh MD, Matthew F Giles MRCP, Jacob S Elkins MD, Allan L Bernstein MD, Stephen Sidney MD. (Jan 2007). Validation and refinement of scores to predict very early stroke risk after transient ischaemic attack. The Lancet.
2. J Donald Easton, Jeffrey L Saver, Gregory W Albers, Mark J Alberts, Seemant Chaturvedi, Edward Feldmann, Thomas S Hatsukami, Randall T Higashida, S Claiborne Johnston, Chelsea S Kidwell, Helmi L Lutsep, Elaine Miller, Ralph L Sacco, American Heart Association; American Stroke Association Stroke Council; Council on Cardiovascular Surgery and Anesthesia; Council on Cardiovascular Radiology and Intervention; Council on Cardiovascular Nursing; Interdisciplinary Council on Peripheral Vascular Disease. (June 2009). Definition and Evaluation of Transient Ischemic Attack: A Scientific Statement for Healthcare Professionals From the American Heart Association/American Stroke Association Stroke Council; Council on Cardiovascular Surgery and Anesthesia; Council on Cardiovascular Radiology and Intervention; Council on Cardiovascular Nursing; And the Interdisciplinary Council on Peripheral Vascular Disease. The American Academy of Neurology Affirms the Value of This Statement as an Educational Tool for Neurologists. Stroke.
3. The International Classification of Headache Disorders 3rd edition. https://ichd-3.org/

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