Migraine is a highly prevalent primary headache disorder, usually considered as benign.

However, migraine is associated with an increased vulnerability to ischemia and stroke, particularly in women with migraine with aura and younger than age 45.

Recent neuroimaging studies characterize structural and functional changes in the brains of patients with migraine that include:

- High frequency of white matter abnormalities,

- Silent infarct-like lesions,

- Volumetric changes in both gray and white matter,

- Altered functional connectivity in both the interictal and ictal phase,

- Abnormal energy metabolism, mitochondrial dysfunction, and additional metabolic changes in the brain.

A better understanding of alterations in the brains of patients with migraine could help not only in the diagnosis but may potentially help develop a targeted anti-migraine therapy.