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migraine without aura, vascular headaches
A migraine is a moderate to severe headache affecting one or both sides of the head.
What is going on in the body?
Migraines are believed to be caused by changes in the blood flow in the vessels of the head. Changes in blood flow to different areas of the brain can produce a variety of symptoms.
What are the signs and symptoms of the condition?
Signs and symptoms of migraine can include: What are the causes and risks of the condition?
The tendency for migraine headaches is probably inherited. Factors that put a person at risk of migraine include: What can be done to prevent the condition?
A person can help prevent migraine headaches by:
A trigger is different from a symptom. A symptom is a condition that accompanies or results from a migraine headache. A trigger is actually something inside or outside the body that can cause or aggravate headache pain. It can be related to something the person does or eats. Other triggers include changes in the weather, fatigue, light, noise, and many other factors.
- avoiding his or her personal triggers
- limiting stress
- exercising regularly
Triggers can include:
Sometimes a headache is triggered by a combination of food and drink. Such food triggers may include:
- bright or flickering lights
- excessive or repetitive noises
- specific smells
- changes in the weather
- changes in the seasons
- high altitudes
- jet lag
- any type of medication, including prescription medications, over-the-counter medications, and herbal remedies
Medications used to prevent a migraine headache include:
- sour cream
- ripened or aged cheeses, including cheddar, Emmenthaler (Swiss), Stilton, Brie, Camembert
- meats that may contain nitrates, such as bacon, sausage, bologna, salami, pepperoni, summer sausage, hot dogs, or pizza
- chicken liver or pate
- pickled or dried herring
- any pickled, fermented, or marinated food
- MSG, or monosodium glutamate, which is found in meat tenderisers, seasoned salt, and soy sauces
- freshly baked yeast products
- sourdough bread
- nuts or nut butters
- broad beans, lima beans, fava beans, and snow peas
- figs, raisins, pawpaw, avocados, and red plums
- citrus foods and drinks
- caffeinated beverages, such as tea and coffee
- alcoholic beverages
- foods or beverages that contain aspartame and phenylalanine
How is the condition diagnosed?
- beta-blockers, such as propranolol
- calcium channel blockers, such as verapamil
- tricyclic antidepressants, such as amitriptyline, and nortriptyline
- anticonvulsants, such as valproic acid, and valproate
- methysergide maleate
Migraine is diagnosed when a person has the following:
There are no blood tests for migraine.
- at least 5 headache episodes, each lasting 4 to 72 hours
- nausea or sensitivity to light and sounds
- at least 2 of the following: one-sided pain, pulsing pain, moderate or severe pain, or pain aggravated by physical activity
Usually a migraine headache can be diagnosed with a complete physical examination and a medical history that includes information about the person's headache experiences. Doctors seldom use other tests to diagnose a migraine but may order some other tests to rule out any other possible causes of the headache. These tests may include:
What are the long-term effects of the condition?
- a cranial CT scan, or examination of the head with a special three-dimensional X-ray
- a cranial MRI, which is a special three-dimensional image made using a magnetic field
- an electroencephalogram or EEG, which is a recording of brain waves
- skull X-rays
- blood tests such as an ESR
- a spinal tap, which involves removing a small amount of cerebrospinal fluid with a thin needle
- an electromyogram or EMG. This test is a recording of the electrical activity of selected muscle groups.
- biopsy of the arteries in the head. This test involves collecting a piece of the artery and examining it under a microscope.
- testing of levels of certain drugs or toxins in the blood
Severe and frequent migraine headaches can greatly affect a person's ability to function. Rarely, a migraine can be associated with a stroke caused by blockage of blood flow in blood vessels.
What are the risks to others?
Although migraines are not contagious, 70% of migraine sufferers do have a family history of migraine.
What are the treatments for the condition?
Treatment for acute migraine attacks includes:
Nonmedication treatments include: (It must be noted that many of the following are not recognised treatments)
- non-steroidal anti-inflammatory drugs or NSAIDs, such as ibuprofen and naproxen
- triptans, such as sumatriptan or zolmitriptan
What are the side effects of the treatments?
Side effects of medications used to treat migraines include stomach upset, drowsiness, and allergic reactions. Nonmedication treatments generally have few side effects but should be discussed with the treating doctor before being used.
What happens after treatment for the condition?
After an effective treatment for migraine is in place, the person can resume normal activities. Rarely, complicated migraines can cause a stroke.
How is the condition monitored?
A person with migraines may be asked to keep a headache diary. Any new or worsening symptoms should be reported to the doctor.
Reviewer: eknowhow Medical Review Panel
Editor: Dr John Hearne
Last Updated: 7/11/2004
Potential conflict of interest information for reviewers available on request