Migraine headaches are primarily characterized by episodes of pain caused by abnormal constriction or dilation of blood vessels, although the exact cause remains unclear. In rare cases, migraines may be related to sinus issues, ear, nose, and throat disorders, or brain tumors.
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Migraine Attack (Image: dw-world) |
Diagnosing a migraine attack is not difficult, primarily relying on the patient’s descriptions, and additional tests are rarely necessary. However, treating and preventing migraines is not straightforward; it heavily depends on the patient’s awareness and understanding of their pain.
Statistics in the U.S. indicate that approximately 20% of women and 6% of men suffer from migraine headaches. This condition can affect individuals of all ages, from children to the elderly, but is most commonly seen in those aged 35 to 45. For individuals over 50, migraine attacks tend to decrease, and some may even completely resolve. Recent studies show that about 75% of migraine cases are linked to genetic factors.
Migraine headaches typically manifest as distinct attacks, lasting several hours and sometimes up to three days.
A typical migraine starts on one side of the temple, or one eye, or one ear, and quickly spreads across the entire same side of the head; it is rare for the pain to cross over to the other side. The pain is severe, causing profuse sweating, and the patient may feel a rhythmic pulsing sensation in their head that mirrors their heartbeat. Accompanying symptoms may include dizziness, nausea, and vomiting. In severe cases, symptoms can mimic a transient ischemic attack, such as sensory disturbances and weakness on one side of the body, double vision, slow thought processes, and difficulty speaking. Changes in posture, exposure to sound, or light can exacerbate the pain, prompting patients to seek refuge in dark, quiet spaces, avoiding contact with others and their environment.
Approximately 30% of patients experience prodromal symptoms 10 to 30 minutes before a migraine attack, such as seeing unusual bright lights in various shapes and colors, perceiving objects only partially or experiencing visual distortions, as well as slowing of thought processes, difficulty speaking, and unilateral weakness.
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Amitriptyline |
About 70% of patients do not experience prodromal symptoms, making it difficult to distinguish between migraines and tension-type headaches. If the headache presents as a clear attack and has occurred more than five times previously, it is likely a migraine.
Factors such as weather changes, excessive noise in living and working environments, life stressors, irregular sleep patterns, dietary habits, alcohol, tobacco, and stimulants can increase the likelihood of a migraine attack.
Women may also experience migraines related to hormonal changes during their menstrual cycle, pregnancy, the use of birth control pills, or hormone replacement therapy, which can alter levels of estrogen and progesterone.
After experiencing several attacks, patients should pay attention to identifying risk factors to implement preventive measures to reduce the frequency of attacks. The International Headache Society recommends that patients maintain a diary to record all relevant information regarding their headaches to assist doctors in developing effective treatment and prevention strategies.
The use of medication for treating and preventing migraine headaches should be carefully prescribed and guided by a physician. For acute treatment, medications should be taken early, as soon as the pain begins, to enhance absorption. Initially, non-steroidal anti-inflammatory drugs (NSAIDs) should be used for acute relief. If the patient does not respond to NSAIDs, triptans, a class of effective acute treatment medications, may be utilized. For patients experiencing more than three migraine attacks per month, preventive medications such as Amitriptyline, propranolol, timolol, divalproex sodium, and methysergide may be considered.
Doctor TRẦN VĂN PHÚC
(Department of Radiology – Xanh Pôn Hospital)
