Risk Factors More Common in Women Than Men Migraine With Aura The prevalence of migraine in the population is 18.5%, and for migraine with aura, it is 4.4%.277 Women are 4 times more likely to have migraines than men.277 Very rarely are migraines associated with stroke, however. Migraine with aura is defined as a typical migraine headache plus the presence of homony- mous visual disturbance, unilateral paresthesias or numbness, unilateral weakness, or aphasia or unclassifiable speech dif- ficulty that might typically precede the migraine headache.278 This type of migraine is associated with double the risk for IS based on meta-analyses of diverse cohorts of patients. The most recently published meta-analysis reported a increase in IS in patients with migraine with aura (OR, 2.51; similar to a previous analysis that showed an OR of 2.16 (95% CI, 1.53 3.03).280 The associa- tion between migraine aura and IS is higher in women than men. In women with migraine with aura, the risk increases even more in those using oral contraceptives (OR, 7.02; 95% CI, 1.51 32.68) and in cigarette smokers (OR, 9.03; 95% CI, The absolute risk of migraine-associated stroke is relatively low. 