Headaches and Migraines

What Causes Headaches and Migraines?

A Headache is a symptom of continuous pain in the head, face, or neck that can last from 30 minutes to several hours, while a migraine is a severe form of headache that manifests as an excruciating pain on one side of the head accompanied by a feeling of sickness and an increased sensitivity to light and sound.

Physiological Mechanisms of Headaches and Migraines

Migraine can be due to a genetic complex familial disorder that is most likely governed by several genes, however, both headache and migraine are caused by trigeminal nerve activation and calcitonin gene-related peptide (CGRP) release from the trigeminovascular system.

The trigeminal nerve transmits sensations of touch and pain in the face and motor functions. These sensations are transmitted through the nerve three major branches: the ophthalmic, maxillary, and mandibular nerves [1].

Calcitonin gene-related peptide (CGRP) is a neuropeptide produced and secreted by the thyroid C cells and stored in the trigeminovascular system, which consists of a complex of sensory neurons that innervate cerebral blood vessels, pial vessels, dura mater, and large venous sinuses.

Once released from these neurons, CGRP has been associated with nociceptive transmission (perception or sensation of pain), and release from perivascular nerve endings causing neurogenic vasodilatation [2]. 

Causes of Headaches and Migraines

Several causes trigger a headache and migraine, and among these, stress, environment, diet, hormones, lack of sleep, and gallbladder disorders, are the main ones.

1. Stress and Migraines

Migraines and headaches are often caused by stress. When a person is stressed, the body releases certain hormones which can trigger migraines and headaches. These hormones can cause the blood vessels in the head to dilate, leading to pain [3].

Additionally, stress can lead to tension headaches, which are caused by muscle contractions in the neck and head. Tension headaches are the most common type of headache, and they can be triggered by stress, fatigue, poor posture, and eyestrain.

2. Diet and Migraines

Many experts believe that diet may play a role. Some foods are known to trigger migraines and headaches, including aged cheeses, processed meats, nuts, and chocolate. Drinking too much alcohol or caffeine can also bring on these unpleasant symptoms [4].

If you suffer from migraines or headaches, it’s important to keep track of what foods seem to aggravate them. Try eliminating suspected triggers from your diet for a few weeks and see if your symptoms improve. You may also want to try eating smaller meals more often throughout the day instead of three large meals. Getting enough sleep and regular exercise can also help reduce the likelihood of migraines and headaches.

3. Gall Bladder and Migraines

The association between the gall bladder and migraines has been shown by a study of 20,427 patients who were diagnosed with gallbladder stone disease (GSD) between 2000 and 2011 from Taiwan’s National Health Insurance Research Database (NHIRD). The study reported a greater cumulative incidence of migraines in patients with GSD compared with those without GSD [5].  

4. Environmental Factors and Migraines

Environmental factors that cause headaches and migraines are associated with seasonal allergies and weather changes that can affect the sinuses.

5. Hormones and Migraines

A link between hormones such as estrogens and migraines has also been reported. This is reflected by the increased frequency of migraines during menstruation [6].

6. Sleep and Migraines

Finally, a lack of sleep is another cause of headaches and migraines. This interaction was shown by a study of 50 migraineurs and which confirmed previous observations that sleep is a common way of ending the headache phase [7].

Headaches and Migraines treatment

Migraines can be debilitating and frustrating. Many people do not know how to treat them. There are many treatments for migraines, but what works for one person may not work for another. Some people find that over-the-counter medications work well (e.g., Ibuprofen or Aspirin), while others need prescription medication.

Some people find that they need to see a neurologist to get help with their migraines. There are also a number of alternative treatments that can help, including acupuncture and chiropractic care.

Conclusion

Although some headaches and migraines appear to be due to a hereditary genetic complex familial disorder, most are due to stress and diet that can be individually controllable through a healthy lifestyle.

Other types of headaches and migraines are periodic due to menstruation in women and environmental changes. However, treatment for gallbladder stone disease is required for related headaches and migraines.

References

[1] https://teachmeanatomy.info/head/cranial-nerves/trigeminal-nerve/

[2] Benemei, S., Nicoletti, P., Capone, J.G. and Geppetti, P., 2009. CGRP receptors in the control of pain and inflammation. Current opinion in pharmacology9(1), pp.9-14.

[3] Sauro, K.M. and Becker, W.J., 2009. The stress and migraine interaction. Headache: The journal of head and face pain49(9), pp.1378-1386.

[4] Finocchi, C. and Sivori, G., 2012. Food as trigger and aggravating factor of migraine. Neurological Sciences33(1), pp.77-80.

[5] Chen, C.H., Lin, C.L. and Kao, C.H., 2018. Gallbladder stone disease is associated with an increased risk of migraines. Journal of clinical medicine7(11), p.455.

[6] MacGregor, A., 2000. Migraine associated with menstruation. Functional neurology15, pp.143-153.

[7] Blau, J.N., 1982. Resolution of migraine attacks: sleep and the recovery phase. Journal of Neurology, Neurosurgery & Psychiatry45(3), pp.223-226.

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