What is migraine?
Migraine headache is a neurological disease affecting approximately 28 million Americans (National Headache Foundation). Migraine is three times more common in women than in men, and children and adolescents also suffer from migraine headache. Migraine headache is a painful, throbbing vascular headache caused by nerve cell production of pain signals, including serotonin and prostaglandins, in response to brain blood vessel constriction followed by expansion. For a visual representation of the onset of migraine headache.

What are the causes and risk factors of migraine?
Migraine awareness is high, and recent medical research indicates that migraines are caused by inherited mutations in genes which control brain activity. Migraines usually develop before the age of 40 and occur more commonly in women than men and in Caucasians more than in African Americans or Asians. Migraine incidence in children is equal in boys and girls, but migraines become three times more common in girls than in boys during adolescence, possibly due to hormonal effects.

Migraine onset begins with the release of serotonin, which can be triggered by stress, particular foods, sensations, medications, or hormone levels. For instance, migraines are induced in some people by glaring light, smells, or noise, or by emotional stress. In addition, lack of sleep, hypoglycemia caused by skipped meals, alcohol (especially red wine), excessive exercise, changes in altitude or weather, or MSG, nitrate, or tyramine-containing foods trigger migraine headache onset in some people.

Women's issues of heightened stress perception and cyclic hormonal fluctuations may account for the increased incidence in women. Medications such as birth control pills, drugs that dilate blood vessels or alter brain blood flow (for example, nitroglycerin, antihypertensives, anti-inflammatories, or bronchodilators), or chronically used head pain remedies can cause migraine headache.

Signs and tests
Your doctor can diagnose this type of headache by asking questions about your symptoms and family history of migraines. A complete physical exam will be done to determine if your headaches are due to muscle tension, sinus problems, or a serious brain disorder.
There is no specific test to prove that your headache is actually a migraine. However, your doctor may order a brain MRI or CT scan if you have never had one before or if you have unusual symptoms with your migraine, including weakness, memory problems, or loss of alertness.
An EEG may be needed to rule out seizures. A lumbar puncture (spinal tap) might be done.

How is migraine treated?
Migraine headache is treated by migraine prevention strategies and symptom alleviation. Many migraine sufferers rely on both preventive and abortive medications to stop the headache process.

Abortive medicine should be taken at the first sensation of migraine headache. Abortive migraine medications are designed to stop the headache process to prevent headache symptoms. Although many are available without a prescription, any medication should be taken strictly as physician recommended since some medicines should not be taken during an aura. Over-the-counter abortive migraine medications include ibuprofen, aspirin, ketoprofen, and naproxen. Prescribed abortive migraine medications include ergotamine, the vasoconstrictor combination of acetaminophen, isometheptene and dichloralphenazone, and serotonin receptor agonists, which include sumatriptan (trade name Imitrex), zolmitriptan (trade name Zomig), rizatriptan (trade name Maxalt), and naratriptan (trade name Amerge). Migraine nose spray, including Zomig and Imitrex nasal sprays, induces migraine relief faster, within 15 minutes, in many people.

Non-medication related abortive therapy includes lying in quiet darkness with a cold compress on the head, massage, and visualization to divert blood flow from the brain.

Prophylactic or preventive therapy includes avoiding inducers or triggers of migraine (such as certain foods, stress, or medications) and improving general health by getting ample rest and moderate exercise, minimizing stress, and eating well.

Prevention?
Understanding your headache triggers can help you avoid foods and situations that cause your migraines. Keep a headache diary to help identify the source or trigger of your symptoms. Then modify your environment or habits to avoid future headaches.
Other tips for preventing migraines include:
• Avoid smoking
• Avoid alcohol
• Avoid artificial sweeteners and other known food-related triggers
• Get regular exercise
• Get plenty of sleep each night
• Learn to relax and reduce stress -- some patients have found that biofeedback and self-hypnosis helps reduce the number of migraine attacks

Complications
Migraine headache is a risk factor for stroke in both men and women.
Migraine headaches generally represent no significant threat to your overall health. However, they can be a long-term (chronic) problem and may interfere with your day-to-day life.