News & Research

Migraines Linked With Brain Damage

As brain cells swell during a migraine, they become starved of oxygen, which may cause brain damage — at least in rats — according to a newly released study. This damage may help explain other findings that people with migraine have a higher risk of stroke. Here’s an excerpt of the article on brain damage and migraine:

“They studied a process called cortical spreading depression, known as CSD, a wave of changes in cells associated with migraine, stroke and head trauma.

“They used a precise two-photon microscopic and oxygen sensor microelectrodes to look at the brains of live mice while they caused this process.

“They saw a swelling occur and the brain cells became starved of oxygen. The nerve cells were damaged — specifically the dendrites, the long, thin spikes that stretch from one nerve cell to another.”

This highlights the importance of using preventives rather than just painkillers during a migraine. Not having a migraine at all prevents other symptoms and the potential for brain damage. In contrast, painkillers treat the pain, they don’t keep the migraine from wreaking havoc on the brain. I’m not sure where triptans fall on this scale, but certainly aborting a migraine is better than having one.

Some good may come from having migraine. A study released last week found that migraine sufferers show less cognitive decline and memory loss than those without migraine.

However, that good news is muddied by other studies showing that people with migraine suffer from brain changes and a risk of brain lesions. Not to mention another new study noted an increased risk of cardiovascular disease.

How much more will it take for people to see that migraine isn’t just about headaches?

Patient Education

An Extra-Special Birthday

My mom turns 61 today. She won’t be happy that I told you all how old she is (she insists she’s 27), but I am because I’m thrilled that she made it to 61. Days before her 60th birthday, she had brain aneurysm rupture. In med speak, it was a subarachnoid hemmorage.

While getting ready for work on that Thursday, she was hit with a sudden terrible headache, unlike any headache she’d had before. She felt sure that it was an aneurysm, but after she and my dad talked about all the people they knew who’d had awful colds in the few weeks before that, she didn’t go to the hospital, thinking she must have a cold.

After working the rest of the week and most of the weekend, she flew to Kansas to visit family. She had been feeling better, but after the flight, her head was raging and she was nauseated, weak, exhausted and disoriented.

Tuesday she went to the ER and had several tests, including a CT scan. Nothing turned up, and the doctor said it was probably a migraine. Nevermind that 60 is a strange age for migraine onset and it was nothing like her previous headaches. When she told me the diagnosis, none of this crossed my mind. I just said, “Oh, OK, what are you taking?” Then I told her that Advil would help more than Tylenol and left it at that.

She was in and out of ERs across Kansas for the rest of the week. She was given fluid and painkillers and doctors did more tests, none of which showed a problem.

Saturday morning she sent my dad to get coffee. He came back to find her passed out on the floor. An ambulance whisked her off to the hospital, where more tests showed that she had an aneurysm rupture that morning. It was actually a re-rupture; the first happened the previous Thursday. Turns out that CT scans show blood in the brain resulting from a rupture and the blood is visible for a short time afterward.

She was airlifted to the Nebraska Medical Center in Omaha, where she stayed almost three weeks and underwent three surgeries.

A year later, I’m happy to say that she is alive and well, with no lingering problems.

Several of the ICU nurses called her survival a miracle. I have to agree. Happy birthday, Mom!

I’m still one to say that more than 90%  of headaches are not caused by catastropic problems, like an aneurysm or brain tumor. But that doesn’t keep headache sufferers (including me) from worrying that they’re in the minority.

To learn more about brain aneurysms, see the Brain Aneurysm Foundation’s information section. Specifically, reading about the symptoms will help ease your mind.

This isn’t just my mom’s one-year anniversary, it’s also Brain Aneurysm Awareness Week 2005. I have yet to see publicity on this beyond the Brain Aneurysm Foundation, but I’ll share it with you if I do.

Mental Health, Patient Education

Coexisting Conditions

“Comorbid” is a word I’m seeing more and more in discussions of migraine. I don’t know if it’s appearing in more patient-centered articles than it once did or if I see it more because I read so much more about migraine than I once did. In any case, it’s something everyone with headache should know about.

Here’s the definition: Comorbidities are disorders that have a greater-than-coincidental association with another disease. According to WebMD, disorders that are thought to be comorbid with migraine including stroke, epilepsy, lupus, Raynaud syndrome, multiple sclerosis, essential tremor, bipolar disease, depression, anxiety disorder, panic disorder and social phobia. Meniere’s disease and certain gastrointestinal disorders are also sometimes mentioned.

It’s like being in high school. Maggie, Ann and Peter are best friends and don’t go anywhere without each other. Ann starts dating Steve and he becomes the fourth member of the group. Does Ann cause Steve to be part of the group? Could he have joined them if he was Maggie’s lab partner and she knew her other friends would like him? What if they all sit next to each other in a class and Steve just naturally joins the group? Does it matter which came first or why?

There aren’t many web resources that catalog and describe comorbidities. The best I’ve found is Headache Disorders: Common Coexisting Conditions. If you want to know if a specific disease is comorbid with migraine, the best online option is to Google both terms together or use both terms and comorbid or coexist.

Patient Education, Resources

Headaches 101

Throbbing, pulsing, pounding, stabbing, tightening, squeezing, jabbing, piercing, paralyzing. You may dismiss the pain as a sinus or allergy headache or panic that you have a tumor or a ruptured aneurysm. In either case, the odds are that you have tension-type headache or migraine that doesn’t follow the typical pattern, but you still have to quell the nagging doubt. Besides, whatever your self-diagnosis or fear, headaches are easier to treat the sooner you find their actual cause.

ABC News has some overview videos that can help you understand your headaches better. These links will take you to each video transcript, where there’s an option to view the video.

The National Headache Foundation is a great resource for more detailed headache information.

2/16/10: It is no longer possible to link directly to the videos. You can access the videos by following the link, then searching for the video title.