Migraines & Headaches Resource Center

OK. It’s been a long day and you are exhausted, stressed, frustrated, skipping dinner (not good) and have a 3″ stack of papers that need to be done tonight and the stack is sitting right where your dinner plate should be.

You take out your Exedrin, Tylenol or whatever for migraines and pour yourself a glass of wine. Wrong move! First of all, researchers have determined that too many over the counter migraine pills or other pain pills can actually make migraines worse. As for the wine, it’s not necessarily a good or safe combination with the medication. In addition, if you look at a list of some of the top things that are migraine triggers, you will find that wine, chocolate and nuts are at the top of the list. If you ever find that you get a migraine after you have one of those substances (or other things particular to you that bring on a migraine), think very carefully about whether or not you should continue eating or drinking any of these items. They are most likely migraine triggers.

I am a migraine sufferer who is also a chocoholic. Thank goodness that chocolate is not a trigger for me. It would certainly be an extremely difficult choice! However, wine – especially red wine – is a major trigger. I am not mch of a drinker but I have a glass of wine on special occasions from time to time. We are talking every few months – one glass. For years I didn’t now what was wrong. I would get home from an awards dinner or a gala of some sort and I would end up with headaches that I cannot explain in words. The pain was so bad at times, I had to be taken to the emergency room where they put me on an I V or gave me a strong shot for pain, for nausea and for sleep. When I woke up 10 to 12 hours later, the headache was usually gone, but I was groggy and felt totally drugged.

After this happened a few times, my doctor and I worked backwards and connected the dots to figure out what was triggering these headaches. We finally nailed it down to one or two things, the number one suspect being the wine. I ate all the other foods without a problem. The only problems that occurred were horrible headaches after a glass of wine. I would get stress headaches and other headaches. At the time, the only real migraine medicine was Imitrix. The doctor made sure I had an ongoing prescription and that I carried them with me in my purse and kept some at home. By stopping drinking any wine, most of the terrible headaches – the worst ones – stopped. If I did get a migraine and took the Imitrix before the symptoms got too bad, the migraine never fully developed.

I rarely get migraines any more. I keep my doctor advised as to what is happening and I have a check up every 3 to 6 months. Migraines are critical to discuss with and deal with your doctor. Many people don’t know that migraines can lead to stroke, aneurysm, eye disorders and more.

Don’t write them off. Find the cause. Work with your doctor. Find the triggers. Find the right medicine – there are many more medications available for migraines than there used to be. Work with your doctor to determine a treatment plan with you including which medication works best for you. Your story – and your migraines – could end happily like mine.

If you are like a lot of people, you sometimes or often get headaches that are horribly debilitating but you just muddle through them. You take some over the counter migraine medication and instead of easing the headache, sometimes it makes the headache worse.

I have suffered from migraines for years. I won’t say how many years, but let’s just say that it has been over 35 years! I have taken non-prescription medicine, put ice on my head and neck, tried to rest in a dark, quiet room and a few other things. Most didn’t work. The ones that did work didn’t work well.

Like you, I could feel the symptoms coming on, and no matter what symptoms I had, I knew that there was a migraine on the way. Lightheadedness, pain in the back or side of the head, nausea and more. No matter what the symptom, I always knew that these were not just regular headaches.

Since I wasn’t getting these headaches every day or even every week, I didn’t run to the doctor. In addition, isn’t it very iteresting that we almost seem to get all the big stuff at night – especially during the middle of the night – or at a party or wedding or important event. If it got really bad, I’d end up in the emergency room and they would give me a shot or two so I could go home and sleep it off.

Over the years, dealing with migraines for most people, there have been many changes and improvements in treatment and medications to choose from that can be used on a regular basis, either daily, weekly, or at the time of the headache. Sometimes I have had to use different medications because some do a better job than others. If you are suffering with these headaches don’t wait – see a doctor. It could be a migraine or other headache, but it could be a headache that could cause an aneurysm or a seizure.

Regardless, the best symptom of a migraine is the feeling of it fading away when the medication works.

There are many things that lead to migraines and many of the actual triggers have less to do than foods like chocolate, nuts, caffeine, wine and a ton of other substances, than they have to do with stress.

It is easy to eliminate the triggers that have to do with foods and other substances. Some are easier than others, but in the long run, it is easier not to drink wine or eat chocolate than it is to eliminate stress, especially in these extremely difficult times.

Researchers have suggested various ideas to help deal with stress to eliminate or at least diminish migraine headaches. Some of the suggestions are:

*When you feel stress coming on, get out – take a walk, get out of the room you are in
if possible – get some fresh air by opening a window or going outside

*Take a power nap – 15 to 30 minutes – just enough to relax you

*Visualize – Think about a place that makes you calm and/or happy

*Do something fun to make yourself laugh – even for 15 minutes. If you can spare a
minute to an hour to relax, you could avoid the migraine and go back to work with
a clear and positive mind ready to work

*Call a friend or loved one and try to meet for lunch or coffee and eep the conversation
positive – don’t brood on the problems

* Do something you like for a short time – bowling, bicycling, hiking, walking, chess,
reading, drawing or anything you really enjoy

At any rate, it is too much stress right now causing too many migraines, and though there is no way to eliminate stress or migraines completely, there are some things to do that can help you overcome stress without taking a lot of time. When you feel stress coming on, stop it before it goes too far. A few minutes to reduce stress will make your work more productive when you get back to it.  And you might not ever end up with that particular migraine.

Migraines have ong been a trouling source of pain. These debilitating headaches are triggered by numerous causes, and for many individuals are a problem daily or nightly.

I am a migraine sufferer and have been for years. Some weeks they are not too bad. Others, I have them most days or nights. If I get one during the day, I lie down in a darkened room, take some medication and hope I fall asleep so that when I wake up, usually the mgraine is over, or at least a lot better. That’s a wonderful feeling. The only problem is that once I have taken medication and sleep – especially deeply – during the day, I find myself sitting up in the middle of the night waiting to get tired.

The doctors have given me sleeping pills in the event that this happens, however, when taking a sleeping pill, it is hard to get up in the morning to do what I have to do. That starts a different cycle. Sometimes it creates another migraine, but usually it leaves me extremely tired and needing to sleep more.

When the situation happens backwards and the migraine happens at night, it doesn’t seem so bad. Trust me, it isn’t fun, but when you take the migraine medication and lie down in a dark room and the medication works, usually – at least if the medicine works – I am able to wake up in the morning usually feeling better. Sometimes I take a sleeping pill at the same time since the migraine pill (which is not meant to be a tranquilizer or sleeping pill), and that way I am able to sleep and wake up feeling better – ready to do what I have to do for the day.

Researchers have discovered that because of all the troubles the world is going through these days, especially because of the incredible financial issues that are affecting everyone, migraines are on the rise. People who never or rarely got migraines before are getting them a lot more these days simply due to stress, which then leads to lack of sleep. Working on both and trying to focus on the positive – no matter how small – will help keep the number and intensity of migraines down and your sleep more regular and peaceful.

If you are a migraine sufferer, there may be good news for you. Researchers have discovered that regular intake of Vitamin B2, ?which is also known as riboflavin, may help you have fewer migraines.

Riboflavin is a type of B vitamin. All B vitamins are water soluble. It is extremely important in converting carbohydrates into sugar. The eight B vitamins, which are also known as vitamin B complex, are necessary to metabolize fat and proteins. They help keep the muscles in good tone and are necessary for the overall health of the digestive and nervous system. They are also necessary for the skin, hair, mouth and liver to stay healthy..

If we have a deficiency in vitamin B or riboflavin, there can be harm to the body, some of it extreme.
There are some serious impacts if we do not get sufficient riboflavin. Headaches, fatigue, visual disturbances, digestive problems, cracks in the mouth, and sensitivity to light are just a few of the impacts.

Riboflavin is found in a sufficient quantity in many foods. Green leafy vegetables, liver, legumes, eggs, milk, cheese, dairy products and fortified cereals are some of the food items which contain riboflavin. The most common reason of riboflavin deficiency is insufficient amount of the vitamin in the diet. Though it is best to get as much riboflavin from food as a source if possible. If it is not possible to do this through diet, a combination of food and vitamin supplements, or even just vitamin supplements without much riboflavin-rich foods will at least help avoid the dficiency or at least make it less severe.

Riboflavin deficiency is a problem for many people of various ages. It is also an unusually severe problem for the elderly.

Riboflavin can be destroyed by light, so any food which contains riboflavin or riboflavin supplements should be kept away from bright light. Also, since riboflavin is a soluble vitamin, it’s benefits can be lost in water when foods are cooked. This can be counteracted by retaining the water which is used to boil vegetables and use the water in cooking other items. There are a number of fortified flours which have riboflavin added to them, as well, however they do not help the body to the extent that whole foods and vitamin supplements do..

If you choose to take supplements, take them with food, usually a meal, so that your body can absorb and use the supplements better. Check with your doctor regarding the level of riboflavin to take, especially if you are taking medications, since various medications can affect the riboflavin and the riboflavin can affect whether the medications and how the medications work. Some of the medications that can have negative interactions with riboflavin include:

Tricyclic antidepressants
Anti-malaria drugs
Various antipsychotic medications
Birth control pills
Doxorubicin (chemotherapy used for some cancers)
Methotrexate
Phenytoin
Probenecid (for gout)
Selegiline (for Parkinson’s disease)
‘Sulfa’ medications – certain antibiotics
Thiazide diuretics
If you are taking riboflavin there are possibilities of allergic reactions. One main side effect (which is not harmful) is that riboflavin may result in urine becoming an orange red color. Allergic reactions in some patients may take place. Avoid overdosing yourself with any supplement containing riboflavin. Ask your family physician or a nutritionist on proper advice.

Studies and testimonies from patients and doctors are showing that there are many people who have been suffering from Migraines who, since taking riboflavin daily, have eliminated most -if not all – of these terrible, painful and debilitating headaches.

It seems like there are a million reasons that people get migraines. There used to be only a few. Of course, there used to be all kinds of ideas as to what these debilitating headaches are, and finally doctors decided they are migraines, and decided they are also real – not something that’s just “in your head.”

So, there are now more ideas as to what causes migraines. The newest culprits that researchers feel trigger migraines might be high temperatures and low air pressure, according to a large study published online today in the Journal of Neurology. But researchers did not find a clear association between headaches and air pollution.

Weather — especially changes in air pressure — is frequently cited as a headache trigger but it had not previously been shown in such a large, well-designed study.

The researchers, from Boston’s Beth Israel Deaconess Medical Center and the Harvard School of Public Health, looked into the idea of pollution as a trigger because fine particulate pollutants cause or complicate other health problems, including heart attacks, stroke, congestive heart failure and asthma.

There were over 7,000 headache patients of both genders and varying ages and ethnic groups in the migraine study, who were seen at the medical center’s emergency room between May 2000 and December 2007. Researchers looked at temperature levels, barometric pressure, humidity, fine particulate matter and other pollutants during the three days before each patient was seen in the ER and for a control day, in which the patient did not report a headache.

Headaches were strongly associated with rising temperatures. An increase of 5 degrees Celsius (9 degrees F, as a reader has so kindly pointed out below) increased the risk of migraine by 7.4%. Low air pressure, which often precedes storms, played a smaller role.

“This study points to the fact that changes in temperature are migraine triggers, and that’s something that’s not been known before,” said Dr. Richard Lipton of the Montefiore Headache Center in New York City.

Knowing what can trigger an attack gives migraine sufferers a measure of control, said Lipton, who was not associated with the study. One of his patients, for example, moved from New York City to Arizona because air pressure in the Southwest is less changeable.

Triggers often work together, so migraines can be brought on by a combination of them. Perhaps red wine or chocolate is a trigger for some people. If there are some weather issues and a migraine sufferer has some chocolate or red wine during a temperature change, the results could be more debilitating than usual. More studies are ongoing to look more closely at the weather as a trigger.

My grandmother had several strokes while I was growing up. This was in the early 1960’s and I had no idea what a stroke was and why she was so sick. The problem is that the doctors didn’t now what the do either. Somehow, they managed to keep bringing her around, get her stable, bring her home let her rest for a few weeks and then hope for the best. They would keep her on a bunch of medication – some for her heart, some for her blood pressure and a few other pills that were for other things that I was never knew what it was for. They looked like a stack of skittles. My grandmother started having strokes when she was in her 50’s. She died of a stroke and a massive hemmoraghe at age 62. She was active until the day she died. The day before she died, whe was on a ladder hanging curtains, happy and singing. You would never know that there was anything wrong with here for a day in her life – certainly not a history of strokes.

A stroke is not a sign of old age. My grandmother proved that. Anyone can have one, no matter your age — and, a new study says this is especially true if you suffer from migraines. Those who suffer from what’s called “migraine with aura” have double the risk of stroke or heart attacks. The headache’s preceded by slurred speech, forgetfulness, feeling hot or cold — and then aura. Out of 175 people, nearly one third of those with migraines had signs of blood vessel damage — which can lead to a stroke.

Beth Leslie had gotten occasional migraines for years. She thought of them as a painful imposition, nothing more. Then, one day two years ago, her world tipped sideways. “Everything was spinning. I just kept my eyes closed, because whenever I’d open them I’d get dizzy,” says Leslie, a 24-year-old veterinary technician who lives in Bowling Green, Ohio. “It really freaked me out.”

She went to the hospital, where a doctor told her she’d probably come down with some sort of virus. After two days, Leslie’s condition hadn’t improved, and her boyfriend started pressing the doctors. They agreed to give her a brain scan, and found she’d suffered a stroke, one that centered on her cerebellum, the part of the brain in charge of balance.

Leslie was shocked. Like most people, she’d thought of stroke as a disease of old age. But for those who get migraines, the rules appear to be different. Until recently, scientists saw migraine suffering as a physiological thunderstorm that left few lasting effects. But new research suggests some migraines aren’t so innocuous.
Recent studies show those who suffer from something called migraine with aura have double, or perhaps triple, the risk of stroke or heart attack, compared with people who don’t get migraines at all
In these people — Leslie is one of them — the headache is preceded by a range of symptoms: slurred speech, forgetfulness, feeling hot or cold, and ghostly lights blinking across the field of vision. That last one is the aura. A third of those who experience migraines have these symptoms; generally, this sub-group also has more frequent, and more excruciating, migraines.

“I don’t think migraine is seen as a serious disorder. That’s a mistake,” says migraine researcher David Dodick, a neurologist at the Mayo Clinic in Phoenix. “Headache is just one manifestation of migraine. It’s a systemic illness.”

The mysteries of migraines
Thirty-five million Americans — 1 in 10 of us — get migraines. They tend to occur regularly, with severe pain on one side of the head. Migraine attacks often include other symptoms, such as nausea and sensitivity to light and sound. Researchers disagree on whether people who get migraines without aura are at higher risk for strokes and heart attacks. So far, almost all of the research of migraine and cardiovascular risk has occurred in those who get auras.

No one knows for sure what accounts for the higher rates of strokes and heart attacks in those who do suffer from migraine with aura, but scientis have several theories that may offer insight. Some researchers blame migraines on chronic exposure to certain neurotransmitters. Most scientists think migraine sufferers’ brains are hyper-excitable — that is, their neurons tend to start firing uncontrollably, with the outburst spreading across the brain over the course of a few hours. This electrical storm causes the brain to release several neurotransmitters, including two chemicals called Substance P and Calcitonin Gene-Related Peptide (CGRP), that produce inflammation and pain in the blood vessels surrounding our brains.

Researchers suspect that over years of repeated migraines, the inflammation from Substance P and CGRP may weaken blood vessels, not only in the head but throughout the body. This damage may raise the risk of stroke or heart attack. During a stroke, the vessels that supply the brain rupture or become blocked; during a heart attack the same thing happens to the vessels around the heart.

In a study of 175 people completed last year, University of Toledo neurologist Gretchen Tietjen — who treated Leslie after her stroke — found that nearly a third of those with migraines had signs of blood vessel damage, almost five times higher than the controls. Tietjen says that while there’s no conclusive proof that Leslie’s migraines played a role in her stroke, they easily could have.

But another group of scientists think the culprit isn’t neurotransmitters, but the vascular system itself. Dodick and others argue that the blood vessels of people who get migraines are inherently dysfunctional, contracting and expanding abnormally in reaction to physical and emotional stress. “People with migraine probably have unusually reactive blood vessels,” says neurologist Richard B. Lipton, a leading migraine researcher at the Albert Einstein College of Medicine in the Bronx. In the head, these vascular spasms could trigger migraines. When the veins and arteries in the temple and skull expand and contract too much, they may press on nerves, leading to the excruciating pain. In people who get migraines, these blood vessel seizures may occur throughout the body, without patients much noticing. Over years, these spasms may damage the vascular system.

Over the past five years, scientists have found that PFOs seem to occur in more than half of people who get migraines. In some migraine patients, closing the PFO with surgery seems to lead to a disappearance of headaches. Some researchers suspect the unpurified blood leaking through the PFO contains inflammatory molecules, which set off that electrical storm when they travel up to the brain. (This may be why people with migraine get headaches after eating certain foods like red wine, olives and chocolate. These “trigger” foods may contain the offending chemicals, which in normal people are constantly removed from the blood.)

Kurth, who has spent several years examining connections between migraine and stroke, thinks there may be several lines of connection between stroke, heart disease and migraine.

At the same time, he says, even those who get frequent migraines shouldn’t panic. In the general population, stroke and heart attack are quite rare. They’re even less common if you’re young and healthy. While the stroke risk might double from 15 per 100,000 in the general population to 30 per 100,000 for those who experience migraine with aura, the risk is still relatively small, pointed out Lipton in the journal Neurology Today.

But if you get migraines, and you smoke, are overweight, or have untreated high blood pressure, then your risk climbs significantly. And each risk compounds the others exponentially. In a 2007 study published, Kurth found that women who have migraine with aura, smoke and take oral contraceptives (also a stroke hazard), were 10 times more likely to have a stroke than women without these risks. Leslie, for example, was taking birth control pills when she had her stroke.

Even without a clear causal link, the new findings may change how doctors treat migraines. Rather than seeing the condition as a painful but harmless hassle, doctors are increasingly trying to prevent it, just as they do obesity or high blood pressure. A range of medicines, including blood pressure drugs and antidepressants, can help prevent headaches. And many patients also find relief through changes in lifestyle and diet.
But if you get migraines, and you smoke, are overweight, or have untreated high blood pressure, then your risk climbs significantly. And each risk compounds the others exponentially.

In a 2007 study published, Kurth found that women who have migraine with aura, smoke and take oral contraceptives (also a stroke hazard), were 10 times more likely to have a stroke than women without these risks. Leslie, for example, was taking birth control pills when she had her stroke.

Changes in treatment
Even without a clear causal link, the new findings may change how doctors treat migraines. Rather than seeing the condition as a painful but harmless hassle, doctors are increasingly trying to prevent it, just as they do obesity or high blood pressure. A range of medicines, including blood pressure drugs and antidepressants, can help prevent headaches. And many patients also find relief through changes in lifestyle and diet.

Although there’s no clear proof, some scientists, including Tietjen, suspect that in migraineurs, preventing headaches could lower the risk of stroke and heart attack.

“I think there’s ongoing, progressive damage to the cardiovascular system,” she says. “If you can treat patients early on, maybe you can keep it from progressing.”

Leslie, who has since fully recovered from her stroke, is now in this minority. She takes Elavil, an anti-depressant, for migraine prevention. She no longer takes oral contraceptives, and last year she had surgery to close a PFO doctors discovered after her stroke. She almost never gets a headache. “It still surprises me that I had a stroke,” she says. “But I’m doing everything I can to stay healthy now. I’ve come a long way.”

more information about DST Health Solutions, contact 800.272.4799, e-mail inforequests@dsthealthsolutions.com or visit www.dsthealthsolutions.com.

Web Site: http://www.dsthealthsolutions.com/

My grandmother had several strokes while I was growing up. This was in the early 1960’s and I had no idea what a stroke was and why she was so sick. The problem is that the doctors didn’t now what the do either. Somehow, they managed to keep bringing her around, get her stable, bring her home let her rest for a few weeks and then hope for the best. They would keep her on a bunch of medication – some for her heart, some for her blood pressure and a few other pills that were for other things that I was never knew what it was for. They looked like a stack of skittles. My grandmother started having strokes when she was in her 50’s. She died of a stroke and a massive hemmoraghe at age 62. She was active until the day she died. The day before she died, whe was on a ladder hanging curtains, happy and singing. You would never know that there was anything wrong with here for a day in her life – certainly not a history of strokes.

A stroke is not a sign of old age. My grandmother proved that. Anyone can have one, no matter your age — and, a new study says this is especially true if you suffer from migraines. Those who suffer from what’s called “migraine with aura” have double the risk of stroke or heart attacks. The headache’s preceded by slurred speech, forgetfulness, feeling hot or cold — and then aura. Out of 175 people, nearly one third of those with migraines had signs of blood vessel damage — which can lead to a stroke.

Beth Leslie had gotten occasional migraines for years. She thought of them as a painful imposition, nothing more. Then, one day two years ago, her world tipped sideways. “Everything was spinning. I just kept my eyes closed, because whenever I’d open them I’d get dizzy,” says Leslie, a 24-year-old veterinary technician who lives in Bowling Green, Ohio. “It really freaked me out.”

She went to the hospital, where a doctor told her she’d probably come down with some sort of virus. After two days, Leslie’s condition hadn’t improved, and her boyfriend started pressing the doctors. They agreed to give her a brain scan, and found she’d suffered a stroke, one that centered on her cerebellum, the part of the brain in charge of balance.

Leslie was shocked. Like most people, she’d thought of stroke as a disease of old age. But for those who get migraines, the rules appear to be different. Until recently, scientists saw migraine suffering as a physiological thunderstorm that left few lasting effects. But new research suggests some migraines aren’t so innocuous.
Recent studies show those who suffer from something called migraine with aura have double, or perhaps triple, the risk of stroke or heart attack, compared with people who don’t get migraines at all.

In these people — Leslie is one of them — the headache is preceded by a range of symptoms: slurred speech, forgetfulness, feeling hot or cold, and ghostly lights blinking across the field of vision. That last one is the aura. A third of those who experience migraines have these symptoms; generally, this sub-group also has more frequent, and more excruciating, migraines.

“I don’t think migraine is seen as a serious disorder. That’s a mistake,” says migraine researcher David Dodick, a neurologist at the Mayo Clinic in Phoenix. “Headache is just one manifestation of migraine. It’s a systemic illness.”

The mysteries of migraines
Thirty-five million Americans — 1 in 10 of us — get migraines. They tend to occur regularly, with severe pain on one side of the head. Migraine attacks often include other symptoms, such as nausea and sensitivity to light and sound. Researchers disagree on whether people who get migraines without aura are at higher risk for strokes and heart attacks. So far, almost all of the research of migraine and cardiovascular risk has occurred in those who get auras.

No one knows for sure what accounts for the higher rates of strokes and heart attacks in those who do suffer from migraine with aura, but scientis have several theories that may offer insight. Some researchers blame migraines on chronic exposure to certain neurotransmitters. Most scientists think migraine sufferers’ brains are hyper-excitable — that is, their neurons tend to start firing uncontrollably, with the outburst spreading across the brain over the course of a few hours. This electrical storm causes the brain to release several neurotransmitters, including two chemicals called Substance P and Calcitonin Gene-Related Peptide (CGRP), that produce inflammation and pain in the blood vessels surrounding our brains.

Researchers suspect that over years of repeated migraines, the inflammation from Substance P and CGRP may weaken blood vessels, not only in the head but throughout the body. This damage may raise the risk of stroke or heart attack. During a stroke, the vessels that supply the brain rupture or become blocked; during a heart attack the same thing happens to the vessels around the heart.

In a study of 175 people completed last year, University of Toledo neurologist Gretchen Tietjen — who treated Leslie after her stroke — found that nearly a third of those with migraines had signs of blood vessel damage, almost five times higher than the controls. Tietjen says that while there’s no conclusive proof that Leslie’s migraines played a role in her stroke, they easily could have.

But another group of scientists think the culprit isn’t neurotransmitters, but the vascular system itself. Dodick and others argue that the blood vessels of people who get migraines are inherently dysfunctional, contracting and expanding abnormally in reaction to physical and emotional stress. “People with migraine probably have unusually reactive blood vessels,” says neurologist Richard B. Lipton, a leading migraine researcher at the Albert Einstein College of Medicine in the Bronx. In the head, these vascular spasms could trigger migraines. When the veins and arteries in the temple and skull expand and contract too much, they may press on nerves, leading to the excruciating pain. In people who get migraines, these blood vessel seizures may occur throughout the body, without patients much noticing. Over years, these spasms may damage the vascular system.

Link between migraine and heart defect?
Then there’s the hole-in-the-heart theory. Researchers have known for years that having a gap in the wall between two chambers of the heart — a surprisingly common defect (it occurs in 10 to 20 percent of people) — increases the risk of stroke. It’s not clear why: The defect, known as a patent foramen ovale, or PFO, may allow blood to bypass the lungs, which constantly filter small clots and impurities from the blood. These clots may end up lodged in veins and arteries in the head, triggering strokes.

Over the past five years, scientists have found that PFOs seem to occur in more than half of people who get migraines. In some migraine patients, closing the PFO with surgery seems to lead to a disappearance of headaches. Some researchers suspect the unpurified blood leaking through the PFO contains inflammatory molecules, which set off that electrical storm when they travel up to the brain. (This may be why people with migraine get headaches after eating certain foods like red wine, olives and chocolate. These “trigger” foods may contain the offending chemicals, which in normal people are constantly removed from the blood.)

‘A very complex system’
But none of these hypotheses have been proven, and the links between migraine and cardiovascular disease remain murky.

“There’s no clear mechanism that convinces me,” says Tobias Kurth, a neuro-epidemiologist at the Harvard University School of Public Health. “It’s likely a very complex system.”

Kurth, who has spent several years examining connections between migraine and stroke, thinks there may be several lines of connection between stroke, heart disease and migraine.

At the same time, he says, even those who get frequent migraines shouldn’t panic. In the general population, stroke and heart attack are quite rare. They’re even less common if you’re young and healthy. While the stroke risk might double from 15 per 100,000 in the general population to 30 per 100,000 for those who experience migraine with aura, the risk is still relatively small, pointed out Lipton in the journal Neurology Today.

But if you get migraines, and you smoke, are overweight, or have untreated high blood pressure, then your risk climbs significantly. And each risk compounds the others exponentially. In a 2007 study published, Kurth found that women who have migraine with aura, smoke and take oral contraceptives (also a stroke hazard), were 10 times more likely to have a stroke than women without these risks. Leslie, for example, was taking birth control pills when she had her stroke.

Even without a clear causal link, the new findings may change how doctors treat migraines. Rather than seeing the condition as a painful but harmless hassle, doctors are increasingly trying to prevent it, just as they do obesity or high blood pressure. A range of medicines, including blood pressure drugs and antidepressants, can help prevent headaches. And many patients also find relief through changes in lifestyle and diet.

“A doubling of risk sounds scary, but in absolute terms, it’s still low,” says Dr. Stephen Silberstein, a migraine specialist at the Jefferson Headache Center in Philadelphia.

But if you get migraines, and you smoke, are overweight, or have untreated high blood pressure, then your risk climbs significantly. And each risk compounds the others exponentially.

In a 2007 study published, Kurth found that women who have migraine with aura, smoke and take oral contraceptives (also a stroke hazard), were 10 times more likely to have a stroke than women without these risks. Leslie, for example, was taking birth control pills when she had her stroke.

Changes in treatment
Even without a clear causal link, the new findings may change how doctors treat migraines. Rather than seeing the condition as a painful but harmless hassle, doctors are increasingly trying to prevent it, just as they do obesity or high blood pressure. A range of medicines, including blood pressure drugs and antidepressants, can help prevent headaches. And many patients also find relief through changes in lifestyle and diet.

Although there’s no clear proof, some scientists, including Tietjen, suspect that in migraineurs, preventing headaches could lower the risk of stroke and heart attack.

“I think there’s ongoing, progressive damage to the cardiovascular system,” she says. “If you can treat patients early on, maybe you can keep it from progressing.”

Leslie, who has since fully recovered from her stroke, is now in this minority. She takes Elavil, an anti-depressant, for migraine prevention. She no longer takes oral contraceptives, and last year she had surgery to close a PFO doctors discovered after her stroke. She almost never gets a headache. “It still surprises me that I had a stroke,” she says. “But I’m doing everything I can to stay healthy now. I’ve come a long way.”

For more information about DST Health Solutions, contact 800.272.4799, e-mail inforequests@dsthealthsolutions.com or visit www.dsthealthsolutions.com.

There is so much research going on regarding migraine headaches and there is progress being made regarding medication, treatment, prevention and more. The only problem is that there are still many people who suffer from migraines and have not found the cure or even treatment or relief.

The following is a story of one of the people who has not found the right treatment or cure yet. She is working with two doctors at the Wasser Pain Management Center. Here is her story, partially reprinted from the communications team at Mt. Sinai Hospital in Toronto, Canada.

At times, Mary-Anne McDermott’s crippling migraine pain gets so bad that it invades almost all her senses. “I used to mostly suffer from light sensitivity. Now it’s light, sound, smell and I become very nauseous which on occasion leads to vomiting,” says McDermott, a patient of the Wasser Pain Management Centre at Mount Sinai Hospital. “I now have six to seven migraines a month, most lasting between three to five days.”

McDermott has suffered from migraine pain since elementary school. Now 30, she has endured a significant increase in the pain she experiences. After a recent visit to the emergency room following five straight days of pain, McDermott decided it was time to see a headache specialist at Mount Sinai Hospital.

The Wasser Pain Management Centre sees 800 to 1,000 new patients each year for everything from nerve pain to pelvic pain. Women make up about 70 per cent of its patients.

Migraine headaches, which affect approximately three times more women than men, can be devastating and lead to disability, dysfunction, missed work or even the loss of a job. Migraine is one of the most common types of pain and yet, physicians can only speculate why women are disproportionately affected.

“At present, we don’t know exactly why migraines are more prevalent in women than in men,” says Dr. Allan Gordon, Director of the Wasser Pain Management Centre and a specialist in the treatment and management of migraine pain. “A number of studies found that pre-pubescent males and females experience a similar rate of migraines, leading to the conclusion that hormones are a significant factor in the cause of the pain.”

During pregnancy, for example, hormonal changes can affect the frequency and severity of migraine headaches in women. About two-thirds of migraine sufferers endure the same level of pain or worse during their pregnancy, while one-third will experience decreased pain or none at all. Like the hormonal ups and downs however, these changes are temporary. For those with reduced pain, migraine symptoms almost always return after pregnancy.

Treatment options for women considering pregnancy are severely reduced. “Many of the pharmacological treatments available for migraines should not be used during pregnancy or for anyone contemplating pregnancy as they may affect fertility and the health of the fetus,” explains Dr. Gordon. “Men do not have to worry about fertility issues and the impact of medication during conception, pregnancy or breastfeeding.”

While women may face more obstacles than men in managing migraine pain, the Wasser Pain Management Centre offers a variety of pharmacological and alternative treatment options such as relaxation therapy, mindfulness and biofeedback. “In managing patients it’s important to address a person’s overall health,” Dr. Gordon says, highlighting the centre’s focus on mental, emotional and physical health.

Dr. Gordon started McDermott on new medication in January 2009 that has helped reduce the number of episodes. For now, this treatment is working well for McDermott and she finds encouragement in Dr. Gordon’s successes. “I’ve heard from many other patients that he is very good and I’m feeling hopeful about my situation,” she says.
Kalin Moon and Michael Power are members of the communications team at Mount Sinai Hospital in Toronto.