It is common for our patients to believe that their migraines are due to a serious pathology involving their brain, and why wouldn’t they? Given how serious the symptoms can be. From theories about blood vessels dilating, white matter appearing on brain scans, and even cancerous tumours, there are plenty of thoughts running through the mind of a migraine sufferer. Luckily, for the overwhelming majority of patients, their migraines are not due to anything sinister, and are therefore not essentially permanent.
What about the white spots on my MRI scan?
Quite often we see MRI scan reports ‘white spots’ on the brain in migraine sufferers. While it can be alarming to see these, there is very rarely anything to be concerned about. In fact, there has been no research that has been able to identify a direct link between having these lesions and having more migraines. These lesions are also found in people who have experienced neurological conditions like stroke and multiple sclerosis, with no causative link. It is thought that the co-morbidities linked with these conditions, blood clots, heart problems etc, are most likely the cause of these spots and not the migraines themselves.
Are my blood vessels dilated?
Historically, migraines were thought to be caused by a dilation of blood vessels in the brain. This was for a couple of reasons. Firstly, the pulsating nature of symptoms allows for an assumption that this is a blood vessel. Interestingly, research repeatedly suggests that there are no changes in dilation or blood flow in the brain of migraine sufferers when compared to non-sufferers. Secondly, migraines can respond well to triptan medications, which can affect the dilation of blood vessels which could confirm the blood vessel hypothesis. Triptan medications also act to decreases sensitisation in the central nervous system, which is a much more likely cause of migraine.
If it’s not those things, then why am I still getting my migraines?
Migraines tend to stick around (or even worsen over time) because an underlying cause is often not found. This is because migraine is now considered a “Primary Headache” which suggests there is no known cause at all. Treatment is then about reducing symptoms as opposed to treating the cause, and the migraine will keep returning.
More modern research suggests that the upper cervical spine (your upper neck) can be responsible for causing a sensitised brainstem, which can be the underlying cause of your symptoms. If a trained headache clinician can identify that this is the specific cause of your migraines, then the faults can be corrected. As the true cause is being treated, a significant change to the frequency, duration, and severity of your migraine can be seen! Most importantly, these symptoms can be treated without surgery or medications.
If you think that our headache clinicians may be able to help you identify the cause of your migraines, then give us a call on 1800 HEADACHE (43 23 22) or visit our website at goldcoastmigrane.com.au to book an appointment.