Prognosis:

For many people, migraines eventually go into remission and sometimes disappear completely, particularly as they age. Estrogen decline after menopause may be responsible for remission in some older women.

Complications

Risk for Stroke and Heart Disease. Migraine or severe headache is a risk factor for stroke in both men and women, especially before age 50. About 19% of all strokes occur in people with a history of migraine. Research indicates that migraine may also increase the risk for other types of heart problems.

Migraine with aura appears to carry a higher risk for stroke than migraine without aura, especially for women. Some studies suggest that people who have migraine with aura are more likely than people without migraine to have cardiovascular risk factors (high cholesterol, high blood pressure) that increase the risk for stroke.

Researchers are also studying the relationship between patent foramen ovale (PFO) and migraine. A PFO is a hole in the wall dividing the upper left and right heart chambers. About half of patients with PFO have severe migraines with aura. Researchers are investigating whether surgical repair of the PFO may help control migraines in patients with this heart condition.

Emotional Disorders and Quality of Life. Migraines have a significant negative impact on quality of life, family relations, and work productivity. Studies indicate that people with migraines have poorer social interactions and emotional health than patients with many chronic medical illnesses, including asthma, diabetes, and arthritis. Anxiety (particularly panic disorders) and major depression are also strongly associated with migraines.

A National Headache Foundation-sponsored survey of migraine sufferers reported that:

• 90% of people with migraines could not function normally on the day of a migraine attack
• 80% experienced abnormal sensitivity to light and noise
• 75% experienced nausea and vomiting
• 30% required bed rest
• 25% missed at least 1 day of work due to migraine in past 3 months