Migraines Linked To Brain Lesions White Matter Damage
New research shows that migraines may not be as benign as we once thought.
People who experience migraine headaches have a greater risk of developing brain lesions and other problems, according to a new study appearing in the journal Neurology.
Traditionally, migraine has been considered a benign disorder without long-term consequences for the brain, study author Dr. Messoud Ashina of the University of Copenhagen in Denmark, said in a press release. Our review and meta-analysis study suggests that the disorder may permanently alter brain structure in multiple ways.
Migraines are severe headaches characterized by throbbing pain as well as nausea and other symptoms. Women are twice as likely as men to experience migraines, according to the . In the study, researchers used six population-based studies and 13 clinical studies to compare migraines long-term effects.Migraine affects about 10 to 15 percent of the general population and can cause a substantial personal, occupational, and social burden, Ashina said.
The researchers found that people with migraines ran a higher risk of brain lesions, abnormalities in brain white matter, and altered brain volume. The latter two have been associated with numerous conditions, including multiple sclerosis and obsessive-compulsive disorder.
Auras are also linked to a 44 percent increase in abnormalities similar to cell death, which is caused by lack of oxygen to the brain.
Migraines And Brain Damage
With so many myths and theories about migraines and why they occur, its really difficult to tell which of them are facts and which are just old wives tales. One of the many migraine myths scientists have busted recently is the theory that people who suffer from chronic and severe migraines are more prone to brain damage and other forms of brain deterioration. Several experts from the British Medical Journal conducted a study on migraines and brain damage or loss of cognitive function. In this extensive study, researchers and analysts took a closer look at the data on more than 6,000 women provided by the Womens Health Study. The women who participated in this study were classified based on their migraine experience and were tested and observed during follow up consultations for a period of two years. By the end of the study, the scientists and experts found no evidence of a link between migraines and cognitive function loss or damage to the brain. This new study dispels any worry caused by a study done in 2007 regarding the occurrence of tiny transient strokes during migraine attacks wherein the flow of blood and oxygen to the brain is disrupted during a migraine which causes long term damage as cells in the brain slowly die.
Contact a Headache Specialist
How Are Migraines Diagnosed
To diagnose a migraine, your healthcare provider will get a thorough medical history, not just your history of headaches but your familys, too. Also, they’ll want to establish a history of your migraine-related symptoms, likely asking you to:
- Describe your headache symptoms. How severe are they?
- Remember when you get them. During your period, for example?
- Describe the type and location of your pain. Is the pain pounding? Pulsing? Throbbing?
- Remember if anything makes your headache better or worse.
- Tell how often you get migraine headaches.
- Talk about the activities, foods, stressors or the situations that may have brought on the migraine.
- Discuss what medications you take to relieve the pain and how often you take them.
- Tell how you felt before, during and after the headache.
- Remember if anyone in your family gets migraine headaches.
Your healthcare provider may also order blood tests and imaging tests to make sure there are no other causes for your headache. An electroencephalogram may be ordered to rule out seizures.
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Are Your Migraines Hurting Your Brain
Neurobiology researchers from Peking University and the Perelman School of Medicine at the University of Pennsylvania recently published a study on the negative effects of sleep deprivation. They subjected laboratory mice to short and long periods of sleeplessness and then looked at their locus coeruleus, the nerves that interact with cognitive function and control alertness in general. The research findings show that long-term loss of sleep can cause brain damage by diminishing brain cells by as much as 25 percent. Like sleep deprivation, migraines can also cause brain damage on a long-term basis. Medical researchers have determined that patients who live with migraine conditions have a significant risk of developing cerebral injuries known as white matter brain lesions.
Million Sufferers In Us
This observation may have direct clinical implications, as several lines of work support the notion that cortical spreading depression constitutes the neurological basis of migraine with aura, and spontaneous waves of CSD may contribute to secondary injury in stroke and traumatic brain injury, the researchers wrote.
Migraine is a severe and debilitating form of headache, affecting 28 million people in the United States alone.
Two studies, including one published last week in the Archives in Internal Medicine, show that people who have migraines are more likely to have heart attacks.
A 2004 study in the British Medical Journal found that migraine sufferers are twice as likely to suffer a stroke as people who do not have the headaches.
Women are much more likely to suffer the characteristic pain of a migraine.
Usual pain medication often has little effect on migraine but a class of drugs called triptans, also called serotonin agonists, and ergotamine drugs, can be used to prevent the worst effects if patients take them at the first sign.
Giving the mice rich doses of oxygen seemed to shorten the duration of the wave of brain effects seen in CSD, the researchers said. They noted that migraine and cluster headache patients are sometimes treated with high-pressure oxygen.
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Can Aura Migraines Damage Your Brain
The results of the study revealed that those who had migraines with aura showed a 68% increased risk of white matter brain lesions, compared with those who did not have migraines. Patients who experienced common migraines showed a 34% increased risk of brain lesions compared with those not suffering from migraines.
Whats A Migraine Journal
- Keeping a migraine journal is not only beneficial to you, but it helps your healthcare provider with the diagnosis process. Your journal should be detailed and updated as much as possible before, during and after a migraine attack. Consider keeping track of the following:
- The date and time of when the migraine began specifically when the prodrome started, if youre able to tell its happening. Track time passing. When did the aura phase begin? The headache? The postdrome? Do your best to tell what stage youre in and how long it lasts. If theres a pattern, that may help you anticipate what will happen in the future.
- What are your symptoms? Be specific.
- Note how many hours of sleep you got the night before it happened and your stress level. Whats causing your stress?
- Note the weather.
- Log your food and water intake. Did you eat something that triggered the migraine? Did you miss a meal?
- Describe the type of pain and rate it on a one to 10 scale with 10 being the worst pain youve ever experienced.
- Where is the pain located? One side of your head? Your jaw? Your eye?
- List all of the medications you took. This includes any daily prescriptions, any supplements and any pain medication you took.
- How did you try to treat your migraine, and did it work? What medicine did you take, at what dosage, at what time?
- Consider other triggers. Maybe you played basketball in the sunlight? Maybe you watched a movie that had flashing lights? If youre a woman, are you on your period?
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When Should I Seek Immediate Help Or Contact My Healthcare Provider
- You are experiencing the worst headache of my life.
- You are having neurologic symptoms that youve never had before, including speaking difficulty, balance problems, vision problems, mental confusion, seizures or numbing/tingling sensations.
- Your headache comes on suddenly.
- You have a headache after experiencing a head injury.
Schedule a visit with your healthcare provider if:
- The number or severity of your headaches increase or your headache pattern changes.
- Your medications no longer seem to be working or youre experiencing new or different side effects.
Whats A Migraine What Does A Migraine Feel Like
A migraine is a common neurological disease that causes a variety of symptoms, most notably a throbbing, pulsing headache on one side of your head. Your migraine will likely get worse with physical activity, lights, sounds or smells. It may last at least four hours or even days. About 12% of Americans have this genetic disorder. Research shows that its the sixth most disabling disease in the world.
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What Are The Four Stages Or Phases Of A Migraine Whats The Timeline
The four stages in chronological order are the prodrome , aura, headache and postdrome. About 30% of people experience symptoms before their headache starts.
The phases are:
It can take about eight to 72 hours to go through the four stages.
When Migraine Mimics Stroke
The symptoms of some types of migraine can mimic stroke, such as hemiplegic migraine where there is weakness down one side.
Migraine auras can be confused with transient ischaemic attack , where someone has stroke symptoms that pass in a short time. For instance, a migraine with only a visual aura but no headache may be mistaken for TIA.
Like a stroke, a migraine can be sudden and can lead to mild confusion. However, migraine aura symptoms tend to develop relatively slowly and then spread and intensify, while the symptoms of a TIA or stroke are sudden.
Migraine can sometimes be mistaken for a stroke caused by bleeding on the brain, called a subarachnoid haemorrhage , which is often characterised by a sudden, very severe headache. Unlike SAH, migraine headache is usually one-sided and throbbing, slow to come on and lasts for a shorter period of time. Vomiting usually starts after a migraine headache starts, but is likely to happen at the same time as headache during a SAH. Patients with a SAH also develop neck stiffness, which is uncommon during a migraine attack.
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Why Am I Seeing Zig Zags In My Vision
What causes ocular migraines.
A migraine that involves visual disturbance is called an ocular migraine.
Ocular migraines can develop with or without the accompanying pain of a classic migraine.
During an ocular migraine, or migraine with aura, you may see flashing or shimmering lights, zigzagging lines, or stars..
Treatment Of White Matter Lesions Associated With Migraine
- Bashir, A., et al. . Migraine and structural changes in the brain: a systematic review and meta-analysis. Neurology 81: 1260-1268.
- Bayram, E., et al. . Incidental white matter lesions in children presenting with headache. Headache 53: 970-976.
- Brownlee WJ. Misdiagnosis of multiple sclerosis. If you have a hammer, everything looks like a nail ? Editorial. Neurology, 2019 92:15-16.
- Candee, M. S., et al. . White matter lesions in children and adolescents with migraine. Pediatr Neurol 49: 393-396.
- De Benedittis, G., et al. . Magnetic resonance imaging in migraine and tension-type headache. Headache 35: 264-268.
- Hamedani, A. G., et al. . Migraine and white matter hyperintensities: the ARIC MRI study. Neurology 81: 1308-1313.
- Palm-Meinders, I. H., H. Koppen, et al. . Structural brain changes in migraine. JAMA 308: 1889-1897.
- Sacco, S. and T. Kurth . Migraine and the risk for stroke and cardiovascular disease. Curr Cardiol Rep 16: 524.
- Sprint MIND investigators . Association of Intensive vs Standard Blood Pressure Control With Cerebral White Matter Lesions. JAMA 322: 524-534.
- Toghae, M., et al. . The Prevalence of Magnetic Resonance Imaging Hyperintensity in Migraine Patients and Its Association with Migraine Headache Characteristics and Cardiovascular Risk Factors. Oman Med J 30: 203-207.
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How Are Headaches Treated
Provided one of the serious conditions noted above is not present, relatively simple treatment options can be considered. To treat symptoms and prevent the frequency and severity of headaches, physicians may try to identify headache triggers, such as stress or certain foods, and recommend treatment options including:
- preventive medications and treatments.
- lifestyle changes, including stress management and relaxation techniques.
- pain-relieving medication, such as acetaminophen or ibuprofen. Children and adolescents should avoid taking aspirin. In rare cases, aspirin can cause Reye Syndrome, a serious and potentially fatal condition.
If your headache is the result of an underlying medical condition or injury, your physician will discuss treatment options with you.
What Commonly Triggers A Migraine
People who get migraines may be able to identify triggers that seem to kick off the symptoms. Some possible triggers include the following:
- Stress and other emotions
- Biological and environmental conditions, such as hormonal shifts or exposure to light or smells
- Fatigue and changes in one’s sleep pattern
- Glaring or flickering lights
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What Is The Prognosis For People With Migraines
Migraines are unique to each individual. Likewise, how migraines are managed is also unique. The best outcomes are usually achieved by learning and avoiding personal migraine triggers, managing symptoms, practicing preventive methods, following the advice of your healthcare provider and reporting any significant changes as soon as they occur.
What Is Happening In The Brain During A Migraine
But during a migraine, these stimuli feel like an all-out assault.
The result: The brain produces an outsize reaction to the trigger, its electrical system firing on all cylinders.
This electrical activity causes a change in blood flow to the brain, which in turn affects the brains nerves, causing pain..
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What Is An Aura
An aura is a group of sensory, motor and speech symptoms that usually act like warning signals that a migraine headache is about to begin. Commonly misinterpreted as a seizure or stroke, it typically happens before the headache pain, but can sometimes appear during or even after. An aura can last from 10 to 60 minutes. About 15% to 20% of people who experience migraines have auras.
Aura symptoms are reversible, meaning that they can be stopped/healed. An aura produces symptoms that may include:
- Seeing bright flashing dots, sparkles, or lights.
- Blind spots in your vision.
- Numb or tingling skin.
What Are Some Migraine Risk Factors And Triggers
Some things make you more likely to get migraine headaches . Other things may bring on a migraine .
Common migraine risk factors include the following:
- Family history: You are much more likely to have migraines if one or both of your parents had migraines.
- Sex: Women are more likely than men to have migraines.
- Age: Most people have their first migraine during adolescence, but migraines can start at any age, usually before age 40.
Common migraine triggers include the following:
- Food and drink: Certain food and drink may cause migraines. Dehydration and dieting or skipping meals may also trigger migraines.
- Hormone changes: Women may experience migraines related to their menstrual cycles, to menopause, or to using hormonal birth control or hormone replacement therapy.
- Stress: Stress may trigger migraines. Stress includes feeling overwhelmed at home or work, but your body can also be stressed if you exercise too much or dont get enough sleep.
- Senses: Loud sounds, bright lights , or strong smells may trigger migraines.
- Medicines: Certain medicines may trigger migraines. If you think your migraines might be related to your medicine, talk to your doctor. Your doctor may be able to prescribe a different medicine.
- Illness: Infections, such as the cold or the flu, may trigger migraines, especially in children.
Foods that may trigger migraines:
- aged, canned, cured, or processed meat
- aged cheese
- soy sauce
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Overestimating The Implications Of Lesions
Goadsby and many other headache specialists say they are confident that the risk of long-term damage is not a cause for concern. Another study they cite to support this is a population-based study from The Netherlands called the CAMERA Study. In this study, researchers compared the brain scans of healthy control subjects and the scans of people with migraine with aura. They re-examined the same subjects nine years later to determine whether people with migraine developed new lesions and whether these lesions were associated with changes in concentration, memory, information processing, and other cognitive tasks, and found that people with migraine had a slight increase in the number of lesions but that there was no evidence of neurological impairment related to these changes.
These same changes can occur in children and adolescents. In addition, age is a known factor that increases the risk of these tiny white matter lesions. The EVA study, a French population-based study on migraine and cognitive decline, conducted brain scans and cognitive function tests on subjects with and without migraine who were born between 1922 and 1932. Again, they found no correlation between the observed brain changes and any evidence of cognitive dysfunction.