Is Migraine Life Threatening? Exploring the Severity of Migraine Attacks

If you suffer from migraine attacks, you’re likely familiar with severe pain, sensitivity to light, and other symptoms. When you’re in the heat of an attack, it is easy to wonder if these horrible attacks are life-threatening. In this detailed article, we will discuss the nature of migraines, potential complications, and the overall risk they pose to your health. Although migraines can be debilitating in nearly every way, it’s crucial to be able to distinguish between the discomfort they cause and any real threat to your life.

Understanding Migraines: Symptomatology and Prevalence

Migraines are a complex neurological condition characterized by recurrent, severe attacks accompanied by intense pain, nausea, vomiting, sensitivity to light and sound, and visual disturbances. Approximately one billion people worldwide suffer from migraines, with women being more commonly affected than men. These debilitating episodes can last for hours or, in some cases, several days, significantly impacting an individual’s quality of life.

Migraine Symptoms: Unpacking the Experience

During a migraine attack, individuals may experience various symptoms beyond headaches. These symptoms can vary from person to person and even from one episode to another. Some individuals may have warning signs known as an “aura,” which can involve visual disturbances like light flashes or blind spots. Other notable symptoms include nausea, vomiting, dizziness, and sensitivity to light and sound. These symptoms can intensify the overall discomfort and substantially impact daily activities.

When you examine migraine with modern imaging techniques, its actually behaves more like a small seizure than a headache. A phenomenon called a “cortical spreading depression” begins in the back of the brain where vision is processed, and moves forward throughout the entire brain. Since it begins in the area where vision is processed, it makes sense that many people will report an aura with visual symptoms that act as a warning sign a migraine is underway. As this depression spreads, areas that are unstable fatigue, and the functions of those areas is temporally suppressed, giving you symptoms. Thus, this pattern of spontaneous activation across the entire brain has led many experts to conclude migraine behaves more like a seizure than a primary headache condition. 

Complications and Risks Associated with Migraines

While migraines themselves are not typically life-threatening, they can occasionally lead to complications that may require medical attention. These complications include:

1. Status migrainosus

• This refers to an intense and prolonged migraine attack lasting more than 72 hours. If left untreated, it can often cause dehydration, which may require medical intervention.

2. Migrainous infarction

• Although rare, migrainous infarction refers to a migraine attack that causes a stroke-like neurological deficit. It is crucial to recognize the signs of migrainous infarction, such as sudden severe headache, difficulty speaking, or weakness on one side of the body, and seek urgent medical attention if suspected. This may also mimic effects of a type of migraine called “hemiplegic migraine.” This unique and often off putting attack can mimic stroke symptoms, leading people to think they ar ehaving a vascular event. 

3. Medication-overuse headaches

• Frequent use of certain pain-relieving medications, such as opioids or triptans, can lead to medication-overuse headaches. These headaches can become chronic and worsen in intensity, making them challenging to treat. Supplementing with liver support and looking into nutrient depletions associated with your medication are easy ways to reduce symptoms associated with medicaiton overuse headaches. (Also referred to as rebound headaches.)

4: Migraine and stroke risk

• Migraines, especially those with aura, may slightly increase the risk of stroke, particularly ischemic stroke. However, the absolute risk is still relatively low. Other factors like smoking and high blood pressure may also contribute to stroke risk. If you have migraines, especially with aura, discuss your risk and preventive strategies with your healthcare provider.

5. Vestibular Migraine and Falls

• Some individuals with migraines may experience vestibular symptoms, such as severe dizziness, vertigo, and impaired balance, during or between attacks. These symptoms often increase the risk of falls and subsequent injuries, particularly in older adults. A good vestibular physical therapist or functional neurology practitioner can help assess and rehab these types of migraine attacks. Strengthening and balancing the vestibular system is a great way to reduce dizziness symptoms during an attack. 

6. Severe Complications

• Intense nausea and vomiting during a migraine attack can lead to electrolyte imbalances, dehydration, or Mallory-Weiss tears (gastrointestinal bleeding). Though rare, these complications may require medical attention.

7: Mental Health Complications

• Migraines can have a large impact on mental health, creating anxiety, panic attacks, and depression. The unpredictable nature of migraine attacks and chronic pain can increase stress and exacerbate symptoms. Seeking support from healthcare professionals such as therapists or psychologists is crucial for managing these psychological effects alongside migraine treatment.

It is important to note that these complications are relatively uncommon and occur in specific situations. However, suppose you experience atypical symptoms or concerns about your migraine attacks. Remember to consult with a healthcare professional to receive appropriate medical guidance in that case.

Managing Migraines: Prevention and Treatment Options

While migraines cannot permanently be eliminated, several strategies can help reduce their frequency and severity. Lifestyle modifications, such as maintaining a regular sleep schedule, managing stress levels, and adopting a healthy diet, can significantly prevent migraine. Additionally, medications like preventive and abortive treatments are available to address migraines. These treatments aim to either reduce the frequency of attacks or alleviate symptoms when an episode occurs. The link above references a more comprehensive list of strategies you can use to minimize symptoms of migraine. 

Life Threatening Headaches

When experiencing a headache, most cases are not associated with severe conditions. However, certain red flags may indicate a potentially serious underlying cause and require immediate medical attention. It is important to note that these red flags are uncommon. Still, suppose you or someone you know exhibits any of the following symptoms. In that case, it is advised to seek prompt medical evaluation:

1. Thunderclap Headache

• A sudden, severe headache that reaches peak intensity within seconds to minutes may indicate a ruptured blood vessel or aneurysm. This should be differentiated from normal headache symptoms that may also be intense in nature. A thunderclap headache happens much faster and typically escalates to an intensity that is far beyond anything you’ve experienced.

2. Headache After Head Injury

• If a headache occurs after a head injury, such as a fall or accident, it may be indicate a concussion or more severe form of brain injury. Rapid progression of double vision, nausea, facial or limb paralysis, confusion, and slurred speech are all things to watch for if you suspect a brain bleed post injury.

3. New or Persistently Worsening Headaches

• Headaches that are new in onset, significantly different from usual, or progressively worsening may warrant medical attention to rule out potential underlying causes.

4. Headache with Neurological Symptoms

• Headaches with neurological symptoms, such as slurred speech, weakness or tingles on one side of the body, confusion, or changes in vision, may indicate a stroke or other neurological conditions. If you’re predisposed to hemiplegic migraines, these symptoms will be worse or different than your usual attacks.

5. Headache with Seizures

• The onset of a headache during or immediately following a seizure may indicate an underlying condition that requires urgent evaluation.

6. Headache with Fever and Stiff Neck

• If you experience a headache accompanied by fever, neck stiffness, sensitivity to light, and altered mental status, it may indicate meningitis, which requires immediate medical attention.

7. Headache in Individuals with a Weakened Immune System

• People with impaired immune systems, such as those with HIV/AIDS or undergoing chemotherapy, who develop headaches may need urgent evaluation, as these headaches can be related to infections or other severe conditions.

8. Headache in an Individual over 50

• New or significant headaches in individuals over the age of 50, especially those with a history of smoking, cancer, or previous head injury, may require medical assessment to rule out potential causes like temporal arteritis or brain tumors.

Remember, while headaches with red flags are uncommon, it is essential not to ignore or dismiss unusual or severe symptoms. Suppose you or someone else experiences these red flags. In that case, it is best to consult a healthcare professional to choose the most appropriate course of action.

Conclusion

Migraines can be excruciating, but they usually aren’t life-threatening. It’s essential to monitor your symptoms, be aware of potential complications, and seek medical attention if needed. While they are not usually immediately life threatening, the compounding effects of migraine can diminish quality of life and predispose you to other complications later on. By working with healthcare professionals and finding suitable treatments, individuals can better cope with migraines and decrease risk for adverse events later in life. 

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*Note: The information provided in this article is for educational purposes only and does not constitute a doctor-patient relationship. Patients are advised to consult their medical provider or primary care physician before trying any remedies or therapies at home.