As outlined on the slide, there is evidence that structural brain changes can occur in people with migraine.[Bashir et al., 2013; Scher et al., 2009; Xie et al., 2018] An emerging body of data suggests that, compared to healthy controls, people with migraine are at an increased risk of clinically silent lesions (e.g., white matter abnormalities and infarct-like lesions), as well as volumetric changes in grey and white matter regions of the brain.[Bashir et al., 2013] Crucially, the clinical significance of these changes is not yet clear.[Bashir et al., 2013] Importantly, there appears to be a link between migraine and stroke risk – possibly because of these structural brain changes – meaning that patients should be evaluated for other stroke risk factors.[Bashir et al., 2013; Dodick, 2009]

References:
Bashir A, Lipton RB, Ashina S, Ashina M. Migraine and structural changes in the brain. A systematic review and meta-analysis. Neurology 2013; 81 (14): 1260–1268.

Dodick DW. Review of comorbidities and risk factors for the development of migraine complications (infarct and chronic migraine). Cephalalgia 2009; 29 (Suppl 3): 7–14.

Scher AI, Gudmundsson LS, Sigurdsson S, et al. Migraine headache in middle age and late-life brain infarcts. JAMA 2009; 301 (24): 2563–2570.

Xie H, Zhang Q, Huo K, et al. Association of white matter hyperintensities with migraine features and prognosis. BMC Neurol 2018; 18 (1): 93.