The first sign of a migraine is often more than a headache. Denver Broncos coach Gary Kubiak, hospitalized with flu-like symptoms after last weekend’s game, was diagnosed with a complex migraine that caused extreme fatigue and body weakness.

In Kubiak’s case, there were deeper concerns. Kubiak suffered a Transient Ischemic Attack, also known as a mini-stroke, at halftime of a game in 2013 while coaching the Houston Texans. The flu-like symptoms he experienced last weekend, when followed by weakness of an arm or leg, numbness, slurred speech or blurred vision, can signal either a migraine or stroke. It’s often hard to tell them apart without testing. After several precautionary tests, including an MRI and CT scan, evidence this time pointed physicians to a migraine, not a stroke.

“A migraine isn’t just a headache,” says Dr. Brian Grosberg, medical director of the Hartford HealthCare Headache Center. “It’s a neurological condition with a constellation of symptoms.”

During a stroke, which can cause permanent brain damage, blood stops flowing in a certain area of the brain because of clotting or bleeding.  This is quite different from a migraine aura, a reversible neurological symptom (or symptoms) occurring gradually over a few minutes and usually lasting less than one hour.  Only 20 percent to 25 percent of migraine sufferers experience an aura. Aura symptoms include visual phenomena such as zigzag lines affecting one half of a person’s visual field, sensory symptoms, weakness or difficulty with language.

“Certainly in Coach Kubiak’s case, and anyone else experiencing neurological symptoms in association with their headache,” says Dr. Grosberg, “a thorough and expedited evaluation should be done to exclude other more worrisome causes.”

Migraine suffers also must learn to avoid triggers, such as flickering or flashing light, stress, certain foods and medications, hormone altitude level changes, hunger and air pressure or altitude changes.

“I’ve made a lot of positive changes health-wise in recent years and will continue to listen to doctors,” said Kubiak, who also will miss Thursday night’s game, in a statement released by the team.

For more information, visit the Hartford HealthCare Headache Center.