Migraine is a risk factor for cerebral stroke, particularly in young women. Whether the migrainous process is a triggering or contributing factor in the ischemic profile, or is the sole cause of stroke, is impossible to establish with certainty. Epidemiological, pathophysiological and clinical evidence are in no way conclusive. The symptoms and lesions of migrainous stroke suggest the involvement of a mechanism similar to that of migrainous aura, although the infarction process is of greater intensity and lasts longer. Migrainous stroke should be considered an evolutionary complication of aura. Thus, the best treatment consists of adequate control of migraine attacks with the reduction of frequency, intensity and duration. The avoidance of migraine drugs with marked vasoconstrictive action, and the removal of other vascular risk factors (smoking and oral contraceptives) are additional measures for the prevention of migrainous stroke.