20% of headaches are migraine headaches. Migraine is a unilateral (75%) headache that is repetitive, lasting for hours, paroxysmal, throbbing, increasing with head movements, and is accompanied by nausea and vomiting. There is a familial predisposition and it is dominantly inherited. It is seen 3 times more in women than in men; It mostly starts at young and middle ages and decreases in advanced ages.
Typically lasts 4 to 72 hours and increases with physical exercise. It has been reported that depression, anxiety and panic disorders are more common in patients with migraine. Various factors are known to trigger headaches in people who are susceptible to migraine. The most well-known among them are certain foods and additives (wine, chocolate, caffeine, cheese), hunger or skipping meals, excessive or insufficient sleep, pungent odors, barometric pressure changes, severe flashing lights, depressed mood, hormonal fluctuations, menstrual bleeding. , medications, and physical exercise. In about 15 of migraine headaches, neurological symptoms called aura, developing within minutes and lasting less than 1 hour, lead. Often, the aura progresses as a visual disturbance that spreads slowly outward from the middle of the visual field. Visual symptoms may be in the form of visual hallucinations in the form of flashing flashes of light, which is considered the simple type, or it may be in the form of blurred vision, in which the visual field is affected. Paresthesias are the second most common aura types. Numbness and tingling sensation may occur unilaterally, starting from the fingers of the person and spreading to the arm, and often affecting the nose and mouth on the same side. Apart from this, speech disorders, dizziness and, rarely, auditory and olfactory hallucinations can also be seen as aura symptoms. Headache usually begins within 5-30 minutes following the aura.
Symptoms in classical migraine include vision loss, strength and sensory disturbances, and headaches that last for a few minutes. The duration of the attack may last for a few hours in classic migraine and a few days in diffuse migraine. Pain may be accompanied by discomfort from light and sound. Symptoms seen in other parts of the body may be findings such as abdominal pain and diarrhea.
Migraine treatment includes avoiding the triggering agents as well as medical treatments. In addition, if migraine attacks occur more than 3 times a month, if the headache is so severe that it interferes with daily life, if it creates a neurological disorder, preventive drug therapy should be added.
Cluster Headache
It is a nervous pain rather than a vascular pain. The exact cause is unknown. The pain comes in the form of severe seizures and ends in an average of 30 minutes. Pain is seen around the eyes, temple, behind the ear and around the lower jaw molars. The pain usually occurs at night and wakes the patient. It is the most severe headache known, so it is also called a suicide headache. It gives a tightening and carving feeling. Autonomic findings such as eye bleeding, tearing in the eyes, nasal congestion, runny nose, sweating on the forehead and face, droopy eyelids, shrinkage of the pupils and swelling of the eyelids are on the same side as the pain. Unlike migraine patients, patients prefer to walk, go out into the open air, and walk instead of lying down in the dark room. The painful period differs from patient to patient. It often takes 2-3 months. The silent period, which is completely painless, is between 6 months and 1 year. During the painful period, pain attacks are seen almost every day, sometimes several times. In 4% of cases, the pain is bilateral. It is more common in men and there is no familial transmission.
There are many drug options for treatment. However, in cases where medical treatment is insufficient, surgical treatment options should be considered.
