In terms of work, lifestyle, family and other relationships, migraine headaches are poorly understood by most people. They can be devastating. The pain can make ordinary tasks impossible until it passes. Unfortunately, many employers are less than understanding that “a little headache” can completely sideline a person for days. The misconception that migraine headaches are just bad headaches is common in society.
Twenty-eight million Americans live with the pain of migraines, yet many don’t understand even the most fundamental information. Out of those numbers, four and a half million suffer more than one attack a month. Twenty-five percent of the female population is affected, and eight percent of all men. Only about half have been formally diagnosed: the disorder is often misdiagnosed both by doctors and patients.
Vascular and Migraines. Migraines are “vascular” headaches, meaning that their source is the contraction and dilation of blood vessels. Originally, vascular headaches were thought to be caused solely by changes in the dilation of blood vessels. More recent research, however, indicates that the nervous system and genetics contribute to the problem.
The exact causes of vascular headaches are a mystery. Some theories hold that nerve fibers surrounding blood vessels give off chemicals that cause the blood vessels to dilate or constrict. Others suggest that brain neuron activity sets off a reaction in the brain stem that causes the facial arteries to become inflamed. Yet another suggests that the brain’s blood vessels spasm, reducing the amount of blood to certain parts of the brain. When the spasm eases, the blood vessels widen, and the sudden dilation causes pain.
Diagnosis. A migraine is best diagnosed by a neurologist, and it’s quite likely that you may be referred to one by your family doctor. The location of the pain and how you describe it are important parts of the diagnosis, but other factors are also considered. Be prepared to answer questions about your family history, and the age at which you began experiencing attacks, their frequency and their duration. Your symptoms will also be compared to those of the different migraine types.
Keeping a Headache Diary. If you suspect you suffer from migraines, keeping a headache diary can help both you and your doctor identify triggers, recognizable symptoms and times when you are most susceptible to attacks. In your headache diary, note the duration of the attack, any preceding symptoms, what you ate, and the time of day: in short, any information that may help explain why it began.