HEADACHE — MIGRAINE – GENERAL INFORMATION
One group of headaches is due to stimulation of pain-sensitive nerve endings in the wall of arteries of the brain or scalp. These are the vascular headaches. The arteries are dilated and this irritates the nerves and causes pain. Migraine is the best known of this group.
When a patient goes to a doctor with the complaint of headache, a proper history is most important. Only in a few cases of headache will there be any abnormal finding on examination or anything abnormal showing on tests.
One famous physician had a favorite saying: “Let me take the history and I will rely on the examination of the most inexperienced medical student.”
In most cases, the astute doctor can arrive at the correct diagnosis on the history alone, but a full medical examination is always necessary to exclude other illness.
X-rays of the skull may be taken and sometimes more invasive techniques, such as a lumbar puncture, where a needle is inserted into the spinal canal and fluid withdrawn for examination under the microscope, are used. Occasionally, air is injected into the fluid canals in the brain.
In a carotid angiogram, a radio-opaque dye is injected into the carotid artery in the neck and X-rays are taken as the dye flows through the arteries of the brain.
A newer, less invasive technique is the brain scan, where a radioactive substance is injected into a vein and its progress through the brain is monitored.
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