Migraine auras are not dangerous on their own, but they signal that a migraine is coming and warrant attention to what triggers them
An aura is a set of visual or sensory symptoms that happen before a migraine headache starts—usually 20 to 60 minutes before the pain begins. You might see flashing lights, zigzag lines, blind spots, or experience tingling in your hands or face. The aura itself does not cause lasting damage to your brain or eyes. However, auras do mean your migraine pattern is more complex than a simple headache, and that pattern matters for how you manage it and when to seek medical attention.
The real concern is not the aura itself but what it tells you about your migraine type and what happens during the migraine process. Some people with auras have a slightly higher stroke risk than people without migraines, but that risk is still small and depends on other factors in your health history. Understanding what your auras mean—and what they do not mean—helps you make better decisions about treatment and when to call a doctor.
Key Takeaways
- Auras are warning symptoms that come before a migraine and do not cause permanent damage to your brain or vision.
- Migraine with aura is a distinct pattern that your doctor needs to know about, because it changes how some treatments work and how your stroke risk is assessed.
- A new aura that looks different from your usual pattern, or an aura without a migraine following it, warrants a call to your doctor to rule out other causes.
- Keeping track of when auras happen, what they look like, and what comes after helps your doctor understand your migraine type and recommend the right prevention strategy.
What happens in your brain during an aura
An aura happens because of a wave of electrical activity that spreads across the surface of your brain. This wave temporarily changes how your brain cells communicate, which produces the visual or sensory symptoms you experience. The wave itself does not injure brain tissue. Once it passes, your brain returns to normal function, and the aura symptoms stop.
The same process that causes the aura also triggers the migraine headache that follows. The electrical wave is followed by changes in blood flow and the release of chemicals that cause inflammation around nerves and blood vessels. This is why auras and migraines are linked—they are part of the same event, not separate problems. Understanding this connection helps explain why preventing the migraine also prevents the aura.
Why auras matter for your medical care
Your doctor needs to know whether your migraines come with auras because it changes how they assess your risk and what treatments they recommend. Migraine with aura is classified differently from migraine without aura in medical terms, and the two patterns can have different implications for your overall health.
If you have migraine with aura and you use certain hormonal birth control methods, your stroke risk increases more than it would with either factor alone. This does not mean you cannot use hormonal birth control, but it means your doctor needs to weigh the benefits against the risk and may recommend a different method. Similarly, some migraine prevention medications work better for people with auras than for people without them. Telling your doctor about your auras ensures they have the full picture of your migraine pattern.
When an aura is a sign to contact your doctor
Most auras follow a predictable pattern for each person. If your auras suddenly change—if they last longer than usual, look different, happen without a migraine following, or occur more often—contact your doctor. These changes can signal something other than migraine and need medical evaluation.
You should also contact your doctor if you experience an aura for the first time as an adult, especially if you are over 40. A first aura later in life is less likely to be migraine and more likely to be another condition that needs diagnosis. Do not wait to see if it happens again; call your doctor or visit urgent care to get it checked.
If an aura is accompanied by weakness on one side of your body, difficulty speaking, severe dizziness, or loss of consciousness, call 911 or go to the emergency room. These symptoms can indicate stroke or another serious condition, even if you have had migraines with auras before.
Stroke risk and migraine with aura
People who have migraine with aura have a higher stroke risk than people without migraines, but the absolute risk is still low. Research shows the risk is roughly two to three times higher, but that means it goes from a very small baseline to still a small number. Most people with migraine with aura never have a stroke.
Your individual risk depends on other factors: whether you smoke, your blood pressure, your age, your family history of stroke, and whether you use hormonal birth control. A doctor can assess your personal risk based on these factors and help you decide what steps make sense. For some people, that means taking a daily migraine prevention medication. For others, it means managing other risk factors like blood pressure or quitting smoking. The point is that your doctor can help you make an informed decision based on your specific situation, not on aura alone.
How to track your auras and share that information
Keeping a record of your auras helps your doctor understand your migraine pattern and spot changes. Write down the date, what you saw or felt during the aura, how long it lasted, and whether a migraine followed. Note anything that seemed different from your usual pattern. Over time, this record shows whether your auras are stable or changing, and whether any triggers seem to set them off.
When you see your doctor, bring this record or be ready to describe your typical aura in detail. Tell them how often auras happen, whether they always lead to a migraine, and whether the aura symptoms are the same each time. This information helps your doctor decide whether your migraine pattern needs a different treatment approach or closer monitoring.
Treatment options when auras are part of your migraine
Because an aura gives you 20 to 60 minutes of warning before the migraine pain starts, you have a window to take medication. Some people take a migraine medication as soon as the aura begins, which can reduce the severity of the headache or stop it altogether. This is different from waiting until the pain starts, when medication may be less effective.
If you have frequent migraines with auras, your doctor may recommend a daily prevention medication to reduce how often they happen. Certain medications work particularly well for migraine with aura. Your doctor can discuss which option fits your situation, based on your other health conditions, other medications you take, and how much the migraines affect your daily life.
Frequently Asked Questions
Can an aura cause permanent vision loss?
No. Aura symptoms are temporary and resolve when the aura ends, usually within an hour. Your vision returns to normal, and there is no lasting damage to your eyes or the parts of your brain that control vision. If you experience vision loss that does not go away after an aura ends, contact your doctor to rule out another cause.
Is it normal to have an aura without a migraine headache following?
It can happen occasionally, but if it becomes a pattern, tell your doctor. Auras that do not lead to migraines are less common and may warrant evaluation to make sure nothing else is causing the symptoms. Your doctor may want to rule out other neurological conditions.
Does having migraine with aura mean I will definitely have a stroke?
No. Most people with migraine with aura never have a stroke. Your risk is higher than someone without migraines, but it remains low overall. Your doctor can assess your personal risk based on your age, family history, blood pressure, and other factors, and help you decide what prevention steps make sense for you.
Can I prevent auras from happening?
You cannot always prevent auras, but you can reduce how often migraines with auras occur by identifying and avoiding your triggers and, if needed, taking a daily prevention medication. Keeping a record of when auras happen helps you spot patterns. Your doctor can recommend specific prevention strategies based on your migraine frequency and how much they affect your life.
Should I stop taking birth control if I have migraine with aura?
That is a decision to make with your doctor, not on your own. Hormonal birth control does increase stroke risk when combined with migraine with aura, but the absolute risk is still low for most people. Your doctor can discuss whether a different birth control method might be safer for you, or whether the benefits outweigh the risk in your specific situation.