There is no relationship between stroke and migraine except in patients who relate these two symptoms. Migraine headaches differ from cluster headaches, which are just as intense. Cluster headaches wake victims from their sleep, while migraines never do. Lying down is intolerable during these headaches. These headaches are brief in duration but may reappear several times in clusters.
Some people can tell from the calendar when to expect cluster headaches.
It was formerly thought that histamine played a role in starting these headaches, but this is no longer a widely held view. Before a series of these strange headaches start, many people report that they have enormous energy and increased libido. Strange as it may seem, people can tear the dural nerve coverings over the spinal cord causing a spinal fluid leak that prevents the brain from floating on fluid inside the cranium. This causes intense pain whenever the victim is in an upright position. I had a patient who did this on a violent roller coaster ride.