Headache and Migraine

What are Migraines?

Headache is a common ailment, but not all headaches are the same. The two most common forms of headache are migraine and tension-type headache. Rarer types of headache include cluster headache, and trigeminal neuralgia. Headache due to brain tumour is fortunately even rarer, and almost never causes headache that has been occurring for 6 months or more.

What are the symptoms of migraine?

The most obvious symptom of migraine is severe headache. Migraine headache usually comes on gradually, but over several hours can become unbearably severe. Any movement aggravates the pain, and most migraine sufferers have to rest until the attack settles. If untreated, the attack can last from four hours to several days. Migraines can be as infrequent as once or twice in a lifetime, or as often as once or twice a week. The most frustrating feature of migraine attack is that it is unpredictable, so you can never be sure that you will be well on a particular day, to keep a particular appointment, to reliably turn up for work, to know that you will be able to care for your children.

Migraine is more than just a headache, at least for most sufferers. During the attack there is often severe nausea or vomiting, which can prevent tablets from being absorbed to stop the attack. Bright light and loud noise aggravate the attack, and so the sufferer searches for a quiet dark room in which to rest. Some migraine attacks temporarily affect sight, with flashing lights and zig-zag disturbances. These are called auras, and they often precede the onset of the headache. Less common auras are pins and needles, or weakness, or interference with speech. Although aura symptoms mimic a stroke, they invariably resolve, although this can take several days.

Tension-type headache is less severe than migraine; is often described as a constant pressure around the head; and does not cause vomiting or aura symptoms. Tension headache can go for days or weeks without relief, but usually does not stop you doing your usual activities. Some people experience both migraine and tension-type headache.

What happens in a migraine attack?

Migraine is a disorder of the brain, which is part inherited and part acquired. The brain over-reacts to various triggers: mental, emotional and physical. The brain itself is insensitive to pain, but the blood vessels that surround and nourish the brain are exquisitely pain sensitive. During a migraine attack, changes in brain activity cause these blood vessels to become inflamed and swollen, which in turn causes the intense pain felt during a migraine attack. Fortunately these vessels are remarkably tough and resilient, and most migraine sufferers live to a ripe old age! Other areas of the brain can become activated, causing aura symptoms, nausea and vomiting, and so on. It was once thought that these blood vessels initially constricted before they swelled, reducing blood flow to part of the brain and causing aura through lack of blood supply. Recent research has shown this to be wrong. Drugs used in treating a migraine attack work on the blood vessels by stopping the inflammation (eg aspirin) or by constricting the swollen blood vessels (eg ergotamine, and newer drugs like sumatriptan). Unlike migraine, research has given us little insight about what happens inside the head during a tension-type headache attack.

For further information about headache and migraine, visit Brain Foundation's Headache Australia* website or call 02 9437 5967.

The Brain Foundation is able to offer Headache & Migraine Information Kits, containing fact sheets about:

  • What Is A Headache?
  • Types of Headache
  • Headache in Children; Headache in Adults
  • Management of Headache
  • Headache Diary
  • Precipitating Factors
  • Treatment of Headache
  • Referral Sources
  • Personal Management and;
  • Useful Websites

Call the Brain Foundation on (02) 9437 5967 to order a copy.

Some useful, reputable Headache and Migraine web sites include:

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                                                   Updated 12 October, 2007