What is a migraine? Why migraine happens. Who gets migraines? Treating migraines.

Is it Migraine?

Fierce Headaches

You've had some fierce headaches, so bad, in fact, that you've decided to see your doctor. Your doctor may be able to diagnose you on the basis of a physical exam and your medical history. However, just to be on the safe side, tests may be ordered to exclude other ailments that share symptoms with migraine headaches.

Ruling Out Process

The ruling out process involves three main diagnostic tests:

Computerized tomography or CT-This test can help your doctor rule out certain infections, tumors, and other medical problems that may be the cause of your headaches. CT is a series of computer-guided x-rays that are able to provide radiologists with cross-sectional images of your brain.

Magnetic resonance imaging or MRI employs radio waves and a very strong magnet to produce a more detailed view of your brain than a CT can provide. MRI scans can help doctors find and diagnose aneurysms, neurological diseases, strokes, tumors, and a host of other abnormalities affecting the brain. An MRI is also a useful tool for examining blood vessels that supply the brain.

Spinal tap or lumbar puncture-Sometimes, a sudden, severe headache is a symptom of a disease such as meningitis or a subarachnoid hemorrhage. Your doctor may want to order a spinal tap to rule out these conditions. A spinal tap yields a sample of your cerebrospinal fluid for laboratory analysis. The test involves inserting a thin needle between two of the vertebrae in your lower back and the procedure takes about half an hour. You may have a feeling of pressure as the fluid is extracted. There may also be headache caused by the drop in cerebrospinal fluid pressure.

In general, a migraine headache is different from other kinds of headaches and a doctor can often make a diagnosis of migraine based on the location and character of your pain. Other factors that will contribute to a diagnosis of migraine include a family history of migraines, your age during your first attack, and the frequency and duration of your attacks. The International Headache Society has created a list of symptoms that characterize common and classic migraines.

Common Migraine (no aura):

*Five or more annual attacks lasting from 4-72 hours

Two of the following symptoms:

*Pain on one side of the head


*Intensity of the pain makes it difficult to function

*Physical activity, for instance climbing stairs, is a trigger

One of these symptoms:

*Nausea and/or vomiting

*Sensitivity to light or sound

Other diseases have been ruled out

Classic Migraine (with aura):

*Two or more annual attacks

Three of the following symptoms:

*One or more symptoms of aura that later subside

*One aura symptom develops over a more than four minutes or two or more aura symptoms that occur in tandem

*Auras last no longer than one hour

*Headache occurs in tandem with or follows aura within one hour

Other diseases have been ruled out