We know there is a big road in the correlation between genes and recurring migraines. Many underlying conditions leading to migraines tend to run in families and there are some inherited disorders that can even cause damage to the arteries in the brain (arteriopathy).  This disorder can cause both migraines and stroke. Initial symptoms usually onset in young adulthood with only isolated symptoms of migraines. However, any young patient with a history migraine that has a stroke must consider one of these genetic disorders. One of the most common is referred to as CADASIL which stands for Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy. Patients with this condition will often first develop migraines and progress to develop recurrent stroke like attacks. Affected patients with imaging studies such as an MRI can show significant damage to the brain. The gene has been isolated for CADASIL and is called Notch-3. Due to the recurring strokes and vascular damage of the brain, patients can develop additional conditions like dementia or behavioral issues in addition to the recurring strokes. There are other genetic disorders that cause similar damage to arteries in the brain with resulting migraines and strokes such as retinol vasculopathy with cerebral leukodystrophy amongst some others that are even more rare. You will learn more about the role of migraines and subsequent damage in future blogs.