Emilia Clarke was at the gym when she had her first stroke. She was 24. She had just finished filming the first season of Game of Thrones as Daenerys, Mother of Dragons. She felt what she later described as an elastic band squeezing her brain.
What followed was a subarachnoid hemorrhage. This type of stroke is caused by a ruptured aneurysm in a brain blood vessel, and it disproportionately affects younger adults, women in particular.
Here is the part I think about:
In my family, we women have migraines. My mother, my aunt, my sister, some of our cousins, and I. Growing up, the family explanation was simple. We get migraines. That's just how we are. You're just like me.
When my mother was younger, back in the eighties, she went in to get it checked. The doctor told her it was a women's problem. That was the whole answer.
She went back in the early 2000s. Different doctor, different decade. The answer was essentially the same. Try to manage your stress. Drink more water.
A women's problem. Go home.
Here is what we know now: migraines, especially migraines with aura, are an established risk factor for ischemic stroke in younger women. It compounds with smoking. It compounds with some forms of hormonal contraception. None of that was part of the conversation my mother had. It was just a women's problem.
I want to be careful here… most migraines are just migraines. A migraine is not a stroke. But the pattern of telling women their neurological symptoms are nothing, that they are hormonal, that they are stress, that they are a women's problem, that pattern has consequences.
It teaches women to wait. And with stroke, waiting is the one thing you cannot do!
This isn't a story about a mean doctor or a bad mother. My mother loved us. The doctors likely meant well. The problem was upstream of all of them. Medicine was not built to take women's pain seriously, and the women in my family inherited the answer they were given. Not because they were defeated. Because no one had ever told them there was a different answer.
I got my own migraines worked up. Root caused. Diagnosed. Treated. That happened because somewhere along the way I stopped accepting the family explanation. Not because I stopped loving the women who taught it to me. Because I started loving them differently.
Two things this week:
One. If you ever have a headache that is suddenly, violently different from any headache you have had before, the kind survivors describe as the worst of their lives, often with vomiting, a stiff neck, sensitivity to light, or loss of consciousness, that is not a migraine. Call 911. Note when symptoms started.
Two. If migraines run in your family, find out whether anyone gets aura. Aura is the visual disturbance some people experience before a migraine. Flashing lights, blind spots, zigzag lines, numbness. Family history of migraine with aura changes the conversation you should be having with your clinician about contraception, about stroke risk, about what to watch for. It almost never makes it into your chart unless you put it there.
Write down what you learn. That's the second node in a family health map.
Emilia Clarke founded SameYou after her recovery, a nonprofit supporting brain injury survivors. The system tends to forget them once the acute danger passes. She didn't.
May your legacy be longevity.
Adriana
Adriana Puram, RN, BSN, CCRN Founder, Kinvera Health
SOURCES
Clarke, Emilia. "A Battle for My Life." The New Yorker, March 2019.
Potter TBH, Tannous J, Vahidy FS. "A Contemporary Review of Epidemiology, Risk Factors, Etiology, and Outcomes of Premature Stroke." Current Atherosclerosis Reports, 2022.
American Heart Association / American Stroke Association Guidelines for the Primary Prevention of Stroke, 2024.
SameYou: sameyou.org