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Vascular Headaches   

Migraine Headaches

What are migraine headaches?

This throbbing type of headache is distinguished by the fact that symptoms other than pain occur with the headache. Nausea and vomiting, lightheadedness, sensitivity to light (photophobia), and other visual disturbances are common migraine symptoms.

Migraines are also unique in that they have distinct phases. Not all individuals experience each phase, however. The phases of a migraine headache may include:

  • premonition phase - a change in mood or behavior that may occur hours or days before the headache.
  • aura phase - a group of visual, sensory, or motor symptoms that immediately precede the headache. Examples include hallucinations, numbness, changes in speech, and muscle weakness.
  • headache phase - period during the actual headache. Throbbing pain occurs on one or both sides of the head. Sensitivity to light and motion is common, as are depression, fatigue, and anxiety.
  • headache resolution phase - pain lessens during this phase, but may be replaced with fatigue, irritability, and difficulty concentrating. Some individuals feel refreshed after an attack, while others do not.

What are the most common types of migraines?

Migraine classification helps to guide treatment. The categories below help to narrow down the classification process.

  • migraine without aura - this more common type of migraine does not include an aura phase (symptoms that come just before the headache).
  • migraine with aura - fewer migraine sufferers have this type of migraine, which is preceded by aura symptoms such as a flashing light, or zigzag lines, for example. These symptoms usually appear within 30 minutes before an attack.

How are migraines diagnosed?

Migraine headaches are diagnosed primarily based upon reported symptoms, but a thorough medical exam, which may include other tests or procedures, may be used to rule out underlying diseases or conditions.

Tracking and sharing information about your headache with your physician helps with the process of making an accurate diagnosis. Consider writing down the following information to take to your medical appointment:

  • time of day when your headaches occur
  • specific location of your headaches
  • how your headaches feel
  • how long your headaches last
  • any changes in behavior or personality
  • effect of changes in position on the headache
  • effect of headaches on sleep patterns
  • information about stress in your life
  • information about any head trauma

Diagnostic tests that may be used to confirm a migraine diagnosis include computerized tomography (CT) scans, magnetic resonance imagining (MRI), and spinal tap. These tests help to rule out other problems such as tumors, infection, or blood vessel irregularities that may cause migraine like symptoms.

Treatment for migraines?

Specific treatment for headaches will be determined by your physician based on:

  • your age, overall health, and medical history
  • type of migraine
  • severity and frequency of the migraine
  • your tolerance for specific medications, procedures, or therapies
  • your opinion or preference

The ultimate goal of treatment is to stop migraines from occurring. Adequate management depends on the accurate identification of the type of headache and may include:

  • avoiding known triggers, such as certain foods and beverages, lack of sleep, and fasting
  • changing eating habits
  • exercise
  • resting in a quiet, dark environment
  • medications, as recommended by your physician
  • stress management

Migraine headaches may require specific medication management including:

  • abortive medications - medications, prescribed by your physician, that act on specific receptors in blood vessels in the head, stopping a headache once it is in progress.
  • rescue medications - medications purchased over-the-counter, such as analgesics (pain relievers), to stop the headache.
  • preventive medications - medications prescribed by your physician that are taken daily to reduce the onset of severe migraine headaches.

Some headaches may require immediate medical attention, including hospitalization for observation, diagnostic testing, or even surgery. Treatment is individualized depending on the underlying condition causing the headache. Full recovery depends on the type of headache and other medical problems that may be present.

Migraine Headaches

What are migraine headaches?

This throbbing type of headache is distinguished by the fact that symptoms other than pain occur with the headache. Nausea and vomiting, lightheadedness, sensitivity to light (photophobia), and other visual disturbances are common migraine symptoms.

Migraines are also unique in that they have distinct phases. Not all individuals experience each phase, however. The phases of a migraine headache may include:

  • premonition phase - a change in mood or behavior that may occur hours or days before the headache.
  • aura phase - a group of visual, sensory, or motor symptoms that immediately precede the headache. Examples include hallucinations, numbness, changes in speech, and muscle weakness.
  • headache phase - period during the actual headache. Throbbing pain occurs on one or both sides of the head. Sensitivity to light and motion is common, as are depression, fatigue, and anxiety.
  • headache resolution phase - pain lessens during this phase, but may be replaced with fatigue, irritability, and difficulty concentrating. Some individuals feel refreshed after an attack, while others do not.

What are the most common types of migraines?

Migraine classification helps to guide treatment. The categories below help to narrow down the classification process.

  • migraine without aura - this more common type of migraine does not include an aura phase (symptoms that come just before the headache).
  • migraine with aura - fewer migraine sufferers have this type of migraine, which is preceded by aura symptoms such as a flashing light, or zigzag lines, for example. These symptoms usually appear within 30 minutes before an attack.

How are migraines diagnosed?

Migraine headaches are diagnosed primarily based upon reported symptoms, but a thorough medical exam, which may include other tests or procedures, may be used to rule out underlying diseases or conditions.

Tracking and sharing information about your headache with your physician helps with the process of making an accurate diagnosis. Consider writing down the following information to take to your medical appointment:

  • time of day when your headaches occur
  • specific location of your headaches
  • how your headaches feel
  • how long your headaches last
  • any changes in behavior or personality
  • effect of changes in position on the headache
  • effect of headaches on sleep patterns
  • information about stress in your life
  • information about any head trauma

Diagnostic tests that may be used to confirm a migraine diagnosis include computerized tomography (CT) scans, magnetic resonance imagining (MRI), and spinal tap. These tests help to rule out other problems such as tumors, infection, or blood vessel irregularities that may cause migraine like symptoms.

Treatment for migraines?

Specific treatment for headaches will be determined by your physician based on:

  • your age, overall health, and medical history
  • type of migraine
  • severity and frequency of the migraine
  • your tolerance for specific medications, procedures, or therapies
  • your opinion or preference

The ultimate goal of treatment is to stop migraines from occurring. Adequate management depends on the accurate identification of the type of headache and may include:

  • avoiding known triggers, such as certain foods and beverages, lack of sleep, and fasting
  • changing eating habits
  • exercise
  • resting in a quiet, dark environment
  • medications, as recommended by your physician
  • stress management

Migraine headaches may require specific medication management including:

  • abortive medications - medications, prescribed by your physician, that act on specific receptors in blood vessels in the head, stopping a headache once it is in progress.
  • rescue medications - medications purchased over-the-counter, such as analgesics (pain relievers), to stop the headache.
  • preventive medications - medications prescribed by your physician that are taken daily to reduce the onset of severe migraine headaches.

Some headaches may require immediate medical attention, including hospitalization for observation, diagnostic testing, or even surgery. Treatment is individualized depending on the underlying condition causing the headache. Full recovery depends on the type of headache and other medical problems that may be present.

Vascular Headaches and Migraines

What are vascular headaches?

Vascular headaches, a group that includes migraines, are thought to involve abnormal function of the brain's blood vessels or vascular system.

What are migraine headaches?

The most common type of vascular headache is migraine - headaches that are usually characterized by the following:

  • severe pain on one or both sides of the head
  • nausea and/or vomiting
  • disturbed vision and intolerance to light

The symptoms of migraine headaches may resemble other conditions or medical problems. Always consult your physician for a diagnosis.

What are the most common types of migraines?

The two most common types of migraines are "classic" migraines and "common" migraines:

  • classic migraines - a type of migraine that involves the appearance of neurological symptoms, called an aura (flashing lights or zigzag lines, or temporary loss of vision) 10 to 30 minutes before an attack. Other classic migraine symptoms may include the following:
    • difficulty with speech
    • weakness of an arm or leg
    • tingling of the face or hands
    • confusion

    Pain associated with classic migraines may be described as:

    • intense, throbbing, or pounding felt in the forehead, temple, ear, jaw, or around the eye.
    • starting on one side of the head, but may spread to the other side.

    An attack may last one or two days.

  • common migraine - a type of migraine that is generally not preceded by an aura, although there may be a variety of symptoms prior to its onset. These may include the following:
    • mental "fuzziness"
    • mood changes
    • fatigue
    • unusual retention of fluids
    • diarrhea and increased urination
    • nausea and vomiting

    Common migraine pain may last three or four days.

What are other types of migraines?

The following are other types of migraines:

  • hemiplegic migraine - symptoms include temporary paralysis on one side of the body (hemiplegia), vision problems, and vertigo, which begin 10 to 90 minutes before the onset of headache pain.
  • ophthalmoplegic migraine - symptoms include pain around the eye, sometimes with a droopy eyelid, double vision, and other sight problems.
  • basilar artery migraine - involving a disturbance of a major brain artery, this type occurs most often in adolescent and young adult women, and is often associated with a woman's menstrual cycle. Pre-headache symptoms may include the following:
    • vertigo
    • double vision
    • poor muscular coordination
  • benign exertional headache - brought on by running, lifting, coughing, sneezing, or bending, this headache begins at the onset of activity, with pain rarely lasting for more than several minutes.
  • status migrainosus - a rare and severe type of migraine that can last 72 hours or longer. Pain and nausea with this headache are often so intense that hospitalization may be necessary.
  • headache-free migraine - a condition that has no head pain, but has other migraine symptoms, such as visual problems, nausea, vomiting, constipation, or diarrhea.

What are other types of vascular headaches?

The second most common type of vascular headache is a toxic headache. Toxic headaches are often produced by a fever that comes with conditions such as pneumonia, measles, mumps, and tonsillitis, as well as the presence of foreign chemicals in the body.

Other kinds of vascular headaches include cluster headaches and headaches caused by a rise in blood pressure.