Did my mom have a stroke or just a migraine headache?

5 answers | Last updated: Nov 16, 2016
Akumaskills asked...

My mom went in the hospital for a stroke but it turned out to be migraine headache that caused stroke- like symtoms. Her speech was very bad but it has come back now. She seems to be air headed, almost like she's not herself. Now this is d day plus 4. How long do you think she will be like this? Will she get better or do you think she may have been misdiagnosed (maybe it is was a stroke)???


Expert Answers

James Castle, M.D. is a neurologist at NorthShore University HealthSystem (affiliated with The University of Chicago) and an expert on strokes.

Migraines are a very cryptic phenomenon, not completely understood by Neurologists.  They cause spasm of the blood vessels, and spreading depression of electrical activity across the brain that can mimic a stroke or TIA (transient ischemic attack).  In my experience, they, along with seizures, are the most common mimic of stroke and TIA.

The most common symptoms from a migraine (which incidentally doesn't always cause a headache - one reason I prefer the term "migraine" or "migrainous phenomenon" rather than "migraine headache") is visual changes (such as flashing lights and wavy lines), speech disturbance, numbness, and tingling.  A migraine can persist for several days, but it is a diagnosis of exclusion - meaning a stroke, seizure, or TIA should be ruled out.

Frequently, an MRI scan is used to diagnose a stroke.  If your mother's symptoms have lasted four days, and if she truly had a stroke, it should almost certainly show up on an MRI.  If the MRI was done too soon after her event, it can be falsely negative.  This is why I ideally wait at least 12 hours from the time the event started before getting an MRI.  If 12 hours has past, the symptoms are still present, and the MRI is negative, there is a very good chance the event was not a true stroke.

I think the best thing to do in this case is to discuss with your doctor whether or not an MRI should be repeated.  If your doctor feels very strongly that the event was not a stroke, perhaps no MRI is needed.  However, if a question remains, it would probably put everyone's mind at ease.  Particularly if done within 3 weeks of the event, a negative MRI would very likely rule out any possibility that she had a stroke.


Community Answers

Yathink answered...

Do prevent permanent brain damage from a stroke...you need a certain type of shot within the first 12 hours......after 4 days it would be irriversible brain damage if it was a true stroke.  I don't agree at all with this answer.


A fellow caregiver answered...

I think after 4 day a stroke is noticible by face, weakness on either side of the body, speach. If your mother is experiencing these systoms she should still be in some ones hospital until thay have given you an answer. Alway follow your first mind when it comes to your love ones because you are the only one that know them best. BE PERSISTANT UNTIL THERE IS AN ANSWER THAT SATISTFIES YOU.


Jionsommer answered...

Keep questioning & advocating for your mother. The fact that you are not accepting the migraine diagnosis as the answer- I think you already have a knowing that she had a stroke. I'm 45 years old and had a stroke 2 years ago. I have Lupus and other auto immune diseases. And for me, also, nothing showed up on the MRI. I had the Dr.'s in the hospital that I was in still not saying that it was a stroke -- even as I was being transfered from their hospital to a re-hab hospital for Stroke!!! It was crazy!!! Just because they could not prove it with a MRI - they would not admit that I had a stroke. My face had drooped the first day, I had visual distortion, numbness & tingling in my left hand, arm, and leg, paralysis, etc., etc. It wasn't until I had my personal rheumatologist called in until things started to happen to help me. I had a spinal tap & they let me leak spinal fluid for 5 days (that's another story) - but I'm so grateful to my rheumatologist because he got them to stop the spinal leak & figured out that I had a stroke. So, keep advocating for your mother - don't take no for an answer. I've since had nueropsychological testing (for cognitive & memory function) - and the Dr. who did this testing after hearing my story said he hears this all too often and told me that neurologists are looked down on in the med. community. Sort of the low ones on the totem pole, and so, if they can't prove something scientifically with a test, you are going to have a really hard time getting them to commit to a diagnosis that they can't "prove". And so, we the patients end up paying for it with sub standard care, and sometimes death, for their ego's. If you have a re-hab facility near you, call it & ask that they come & evaluate your mom for admission to begin care & treatment & ask for a hospital case manager/advocate too. Best of luck to you & your Mom!


A fellow caregiver answered...

Strokes don't ever resolve themselves.

Because not everyone knows what TIAs (Transient Ischemic Attacks) are, those are the ones that typically resolve themselves 24-48hrs after the event. With CVAs (Cerebrovascular Accidents 'Strokes') they don't resolve without intervention. Time Is Brain....

If it's caught early enough, and isn't due to hemorrhage of the blood vessels in the brain, Thrombolitics (Clot Busters) are normally used to clear the occlusion. And that's only if a patient can be given them....

Something I learned today: Another telltale sign of Stroke; AFib (Atrial Fibrillation). Not something you would be able to see without a 12 lead EKG (Electrocardiogram).