I was one on those people who got headaches rarely. And I never had migraines even though the overwhelming number of my friends did. I’m lucky in that respect. But I had a stroke and no TBI. So I’d call that situation sort of even.
Let’s start this blog post with the difference between a regular, common headache and often debilitating migraine in which you have to pause the activity you have attempted to complete:
Headache:
- A feeling like your head is being smushed
- Moderate pain that occurs on both sides of the head
- Tight pressure in the head
- Pain and/or tightness in the neck or shoulders
- Soreness in the temple
Migraine:
- Intense or severe pain that is worse on one side or occurs only on one side
- Pressure and pain behind the eyes
- Pain in the temples
- Nausea and vomiting
- Pain that worsens with physical activity
- Sensitivity to light, sounds, or smells
- Lightheadedness and dizziness
After a traumatic brain injury (TBI), the odds of a migraine go dramatically up. A migraine is a chronic neurological disease characterized by periodic onslaughts of severe headaches, often accompanied by other debilitating symptoms. Unlike a ordinady headache, a migraine attack can pause a person’s daily life that last from hours to days.Â
- A throbbing or pulsing pain, typically on one side of the head that can be so severe, it is extremely disabling.
- Extreme sensitivity to smells or touch, light (photophobia), or sound (phonophobia).
- Many people experience nausea, and some may vomit, which can further interrupt daily tasks.
- About one-quarter of people with migraines experience an “aura,” which consists of temporary, reversible neurological symptoms that occur before or during the headache phase. These most often include visual disturbances like flashes of light, zigzag lines, or blind spots, but can also cause tingling, numbness, or speech difficulties.
- Fatigue, neck stiffness, dizziness, lightheadedness, and mood changes are also common.Â
- Prodrome:Â Occurs hours or days before the headache. Subtle warning signs may include mood changes, food cravings, neck stiffness, and frequent yawning.
- Aura:Â Happens for some people right before or during the headache phase and can last up to an hour. These are the visual or other sensory disturbances.
- Headache:Â The pain phase, which can last from 4 to 72 hours if left untreated.
- Postdrome:Â The “migraine hangover” phase that occurs after the pain subsides. Symptoms can include fatigue, confusion, mood changes, and neck pain.Â
- Bright or flashing lights, strong smells, and changes in the weather or barometric pressure can also be triggers.Â
- Stress, a very common trigger, and managing stress is an important part of prevention.
- Fluctuations in estrogen, particularly around the menstrual cycle, pregnancy, or menopause can trigger attacks.
- Both a lack of sleep and oversleeping can act as a trigger.
- Certain foods like aged cheeses, processed foods, chocolate, or caffeine, as well as skipped meals, can trigger migraines in some people.
The migraine can persist for months or years after the initial injury. Post-traumatic migraines can develop even from mild concussions. Studies have shown that individuals with a TBI have a higher risk of subsequently developing a migraine disorder compared to those without a TBI.
Headache is one of the most common and persistent symptoms after a TBI, often referred to as Post-Traumatic Headache (PTH). The most common type of PTH mimics a migraine, with symptoms like:
- Throbbing pain
- Worsening with physical activity
- Nausea and/or vomiting
- Sensitivity to light (photophobia) and sound (phonophobia)
Individuals who already had a history of migraines before the brain injury are at a higher risk for developing chronic or persistent post-traumatic headaches, and their existing migraine condition can become worse or more frequent. While headaches are common across all severities of TBI, some studies indicate that the risk of developing a headache or migraine increases with the severity of the injury.
Those points stand to reason. Some stroke survivors experience new-onset migraines though the risk varies depending on the location and type of stroke. Tumors, infections, degenerative diseases can also trigger migraines. Additionally, there were damage to pain-processing pathways and changes in blood flow regulation in the brain. Inflammation and structural changes altered sensitivity to pain signals, too.
Here are the key points on the relationship between TBI and migraines. Traumatic brain injury, even a mild one like a concussion, is a recognized risk factor for developing new-onset migraine. Studies have shown that individuals with a TBI have a higher risk of subsequently developing a migraine disorder compared to those without a TBI.
There is no cure for migraines, but treatment is available to manage symptoms and prevent attacks.Â
- Acute treatments: Medications taken at the beginning of an attack stop these symptoms. These include over-the-counter pain relievers for mild migraines and prescription medications for more severe attacks.
- Preventive treatments:Â Medications taken regularly to reduce the frequency and severity of migraines. These are often used by people who have frequent, severe, or long-lasting attacks.
- Lifestyle management: Avoiding personal triggers, maintaining a consistent sleep schedule, eating regular meals, exercising regularly, and practicing relaxation techniques can help manage or prevent migraines.Â
If you experience migraine symptoms, especially if they are new, severe, or different from your usual headaches, you should consult a healthcare professional for a diagnosis and treatment plan.
One of the stars on Home Improvement, Jonathan Taylor Thomas, said, “I can’t tell you how many shows I’ve done with full-blown migraine headaches.”
You’re a real trooper, Jonathan!
