Medical Encyclopedia


Medical Encyclopedia

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Contents of this page:


Migraine headache
Migraine headache
Migraine cause
Migraine cause
CT scan of the brain
CT scan of the brain
Central nervous system
Central nervous system

Alternative Names    Return to top

Headache - migraine

Definition    Return to top

A migraine is a common type of headache that may occur with symptoms such as nausea, vomiting, or sensitivity to light. In many people, a throbbing pain is felt only on one side of the head.

Some people who get migraines have warning symptoms, called an aura, before the actual headache begins. An aura is a group of symptoms, usually vision disturbances, that serve as a warning sign that a bad headache is coming. Most people, however, do not have such warning signs.

See also:

Causes    Return to top

A lot of people get migraines -- about 11 out of 100. The headaches tend to first appear between the ages of 10 and 46. Occasionally, migraines may occur later in life in a person with no history of such headaches. Migraines occur more often in women than men, and may run in families. Women may have fewer migraines when they are pregnant. Most women with such headaches have fewer attacks during the last two trimesters of pregnancy.

A migraine is caused by abnormal brain activity, which is triggered by stress, certain foods, environmental factors, or something else. However, the exact chain of events remains unclear.

Scientists used to believe that migraines were due to changes in blood vessels within the brain. Today, most medical experts believe the attack actually begins in the brain itself, where it involves various nerve pathways and chemicals. The changes affect blood flow in the brain and surrounding tissues.

Migraine attacks may be triggered by:

Certain foods and preservatives in foods may trigger migraines in some people. Food-related triggers may include:

This list may not be all-inclusive.

True migraine headaches are not a result of a brain tumor or other serious medical problem. However, only an experienced health care provider can determine whether your symptoms are due to a migraine or another condition.

Symptoms    Return to top

Vision disturbances, or aura, are considered a "warning sign" that a migraine is coming. The aura occurs in both eyes and may involve any of all of the following:

Not every person with migraines has an aura. Those who do usually develop one about 10-15 minutes before the headache. However, it may occur just a few minutes to 24 hours beforehand.

Migraine headaches can be dull or severe. The pain may be felt behind the eye or in the back of the head and neck. For many patients, the headaches start on the same side each time. The headaches usually:

Other symptoms that may occur with the headache include:

Symptoms that may linger even after the migraine has gone away include:

Exams and Tests    Return to top

Your doctor can diagnose this type of headache by asking questions about your symptoms and family history of migraines, and by monitoring how you respond to treatment. A complete physical exam will be done to make sure that your headaches are not due to muscle tension, sinus problems, or a more serious underlying brain disorder.

Tests are usually not needed if you have typical signs and symptoms of migraines. However, your doctor may order a brain MRI or CT scan to rule out other causes.

If you have a migraine with unusual symptoms such as weakness, memory problems, or loss of alertness, an EEG may be needed to rule out seizures. Rarely, a lumbar puncture (spinal tap) might be done.

Treatment    Return to top

There is no specific cure for migraine headaches. The goal is to prevent symptoms by avoiding or changing your triggers.

A good way to identify triggers is to keep a headache diary. Write down:

For example, the diary may reveal that your headaches tend to occur more often on days when you wake up earlier than usual. Changing your sleep schedule may result in fewer migraine attacks.

When you do get migraine symptoms, try to treat them right away. The headache may be less severe. When migraine symptoms begin:

Many different medications are available for people with migraines. Medicines are used to:


If you have frequent migraines, your doctor may prescribe medicine to reduce the number of attacks. Such medicine needs to be taken every day in order to be effective. Such medications may include:


Other medicines are taken at the first sign of a migraine attack. Over-the-counter pain medications such as acetaminophen, ibuprofen, or aspirin are often helpful, especially when your migraine is mild. (Be aware, however, that overuse or misuse of such pain medications may result in rebound headaches.) If these don't help, ask your doctor about prescription medications.

Your doctor can select from several different types of medications, including:

These medications come different forms. Patients who have nausea and vomiting with their migraines may be prescribed a nasal spray or injection instead of pills.

Some migraine medicines narrow your blood vessels and should not be used if you are at risk for heart attacks or have heart disease, unless otherwise instructed by your healthcare provider. Ergots should not be taken if you are pregnant or planning to become pregnant, because they can cause serious side effects to an unborn baby.


Other medications are primarily given to treat the symptoms of migraine. Used alone or in combinations, these drugs can reduce your pain, nausea, or emotional distress. Medications in this group include:

If you wish to consider an alternative, feverfew is a popular herb for migraines. Several studies, but not all, support using feverfew for treating migraines. If you are interested in trying feverfew, make sure your doctor approves. Also, know that herbal remedies sold in drugstores and health food stores are not regulated. Work with a trained herbalist when selecting herbs.

Support Groups    Return to top

American Council for Headache Education -

The National Migraine Association -

National Headache Foundation -

Outlook (Prognosis)    Return to top

Every person responds differently to treatment. Some people have rare headaches that require little to no treatment. Others require the use of several medications or even occasional hospitalization.

Possible Complications    Return to top

Migraine headaches generally represent no significant threat to your overall health. However, they can be a long-term (chronic) problem and may interfere with your day-to-day life.

When to Contact a Medical Professional    Return to top

Call 911 if:

Such headaches may be the result of stroke, bleeding in the brain, aneurysm, or other serious condition and require the immediate attention of a health care provider.

Depending on the history of the headache, a CT scan or MRI may be done to rule out any of the above conditions.

Also, call your doctor if:

Prevention    Return to top

Understanding your headache triggers can help you avoid foods and situations that cause your migraines. Keep a headache diary to help identify the source or trigger of your symptoms. Then modify your environment or habits to avoid future headaches.

Other tips for preventing migraines include:

References    Return to top

Wilson JF. In the clinic. Migraine. Ann Intern Med. 2007: 147(9): ITC11-1-ITC11-16.

Ebell MH. Diagnosis of migraine headache. Am Fam Physician. 2006: 74(12): 2087-8.

Detsky ME, McDonald DR, et al. Does this patient with headache have a migraine or need neuroimaging? JAMA. 2006: 296(10): 1274-83.

Lipton RB, Bigal ME, Steiner TJ, Silberstein SD, Olesen J. Classification of primary headaches. Neurology. 2004;63(3):427-35.

Silberstein SD, Young WB. Headache and Facial Pain. In: Goetz, CG. Textbook of Clinical Neurology. 3nd ed. St. Louis, Mo: WB Saunders; 2007: chap. 53.

Update Date: 7/27/2008

Updated by: Daniel B. Hoch, PhD, MD, Assistant Professor of Neurology, Harvard Medical School, Department of Neurology, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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