Headaches (Migraine)

Overview


Plain-Language Overview

Headaches (Migraine) are a common neurological condition characterized by intense, often throbbing pain usually on one side of the head. They involve the nervous system, particularly the brain and its blood vessels. Migraines can cause additional symptoms such as nausea, sensitivity to light and sound, and visual disturbances called auras. These headaches can significantly affect daily activities and quality of life. The exact cause is not fully understood but involves changes in brain chemistry and nerve signaling. Migraines often occur in episodes lasting hours to days and may be triggered by various factors like stress, certain foods, or hormonal changes.

Clinical Definition

Headaches (Migraine) are a primary headache disorder defined by recurrent attacks of moderate to severe unilateral, pulsatile headache lasting 4 to 72 hours. The core pathology involves neuronal hyperexcitability and cortical spreading depression, leading to activation of the trigeminovascular system and release of vasoactive neuropeptides such as calcitonin gene-related peptide (CGRP). This causes neurogenic inflammation and vasodilation of intracranial blood vessels. Migraines are often accompanied by prodromal symptoms, aura (focal neurological symptoms), and autonomic features like nausea and photophobia. Genetic predisposition plays a role, with mutations in ion channel and neurotransmitter-related genes contributing to susceptibility. The condition is clinically significant due to its high prevalence and impact on functional status.

Clinical Presentation


Diagnostic Workup


Pathophysiology


Treatments


Prevention


Outcome & Complications


Differential Diagnoses


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