Migraines and Chronic Headaches
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The migraine headache is perhaps the best known special type of headache. It is really called the migraine syndrome. By syndrome we mean that a lot of things accompany the headache – all of them bad. Symptoms include dizziness, visual problems, “spots” before the eyes, redness, swelling, tearing of the eyes, muscle contraction, irritability, nausea, vomiting, constipation, or diarrhea. These symptoms often arise before the headache hits. The headache itself may last for a few minutes to a few days, and the severity may range from minor discomfort to immobilizing agony.
The migraine pain is most common in the temple, but it may be experienced anywhere in the head, face and neck.
A variety of headache, closely related to the migraine, is the cluster headache. Attacks come on abruptly with intense, throbbing pain arising high in the nostril and spreading to behind the eye on the same side. Sometimes, the forehead is also affected. The attacks tend to occur from once to several times daily in clusters lasting weeks, or even months. Without apparent reason, the cluster subsides as quickly as it began.
So what puts the ache in headache? The pain-sensitive structures of the head are the culprits. These are the arteries of the brain and skull, the tissues surrounding the head veins, the dura mata covering over the brain, and certain nerves called cranial nerves. When these parts are inflamed, stretched, pulled, or under pressure, any type of headache may be caused.
Migraine headaches can be classified into two types: classical and common. The classical migraine is a headache that follows an aura or some type of spontaneous event such as numbness or tingling. The aura may be flashes of light, squiggly lines, or a halo effect. The common migraine does not have an aura associated with it. Most people who suffer from migraines suffer from common migraines – usually at a 3:1 ratio.
Approximately 28 million Americans suffer from migraines, and millions go without treatment. Scientists once thought migraines were caused by abnormally dilated or enlarged blood vessels. Now, new imaging devices have allowed them to watch brains during migraine attacks, and scientists are discovering that sufferers have abnormally excitable neurons or brain nerve cells.
The latest migraine research has yielded a mechanism called cortical spreading depression, or CSD. Prior to the onset of pain in a migraine, researchers have observed a sudden burst of cortical activity that occurs most commonly in the occipital lobes (back part of the brain). The occipital lobe will increase in frequency of firing, or have a burst of activity, and then there will be an episode of silence or depressed activity. The actual activity of the brain becomes depressed when compared to normal. The resulting pain comes from either the brain stem activation or from blood vessels inflamed by rapidly exchanging blood flow – or both.
I take a different approach to the treatment and prevention of headaches and migraines. After a thorough neurological examination I determine which part of the nervous system is not functioning properly. In many headache and migraine patients I may find a high mesencephalic output.
There are three parts to the brain stem: top, middle, and lower. The mesencephalon is the top part of the brain stem. A high output of the mesencephalon will cause an increased pulse and heart rate, inability to sleep or waking up from fitful sleep, urinary tract infection, increase warmth or sweating, and sensitivity to light.
Along with a high mesencephalic output, the patient may have a decreased output of the cerebellum. The cerebellum is in the back part of the brain, and it controls all of the involuntary spinal musculature.
No matter what the condition, it is imperative that the doctor performs a thorough and comprehensive exam to determine the exact nature of the patient’s condition.
If you are interested in seeing if you are a candidate for our breakthrough procedures for treating migraines and chronic headaches, please give us a call at (252) 758-2222 to schedule a free consultation with Dr. McCarthy.