Headaches and Migraines

Doctors have yet to definitively decide the whys and wherefores of headaches. There are no nerve endings within the brain to create "pain," so why we can have headaches is a mystery. So, too, is a riddle that some people can have headaches and others - blessed that they are - never experience a single one.

Doctors do know some causes for headaches. Trauma - a bump to the head - can cause a headache; also hunger, dehydration, lack of sleep, too much sleep, hangovers (from alcohol, actually a combination of low blood sugar and dehydration), noise, eye strain, and muscle tension in the neck and shoulders (often caused by stress).

Aspirin - in its pure form a preparation of bark from the unassuming willow tree - is a known blood-thinner, and quite effective on most common headaches, which leads some to believe that headaches might be caused in part by increased blood pressure within the skull. (Of course, if your headache is caused by lack of food, water, or sleep, aspirin will not help you.)

More, on migraines:

Migraines are another matter. A migraine is a headache on steroids - bigger, stronger, with a nasty temper. Most come with extra concerns: sensitivity to light, noise, scents, even motion; nausea, dizziness, or light-headedness can occur as well. There are different kinds of migraines, and like their tamer cousins, not much is known about their causes. But unlike regular headaches, some migraines can actually cause tiny bits of damage to the brain as they occur.

I'm so special, I get to have three different kinds of migraines, and possibly a fourth (I'm still debating that with the doctors).

The "classic" or tension migraines are the most common type; they are usually caused by stress and can be treated with many over-the-counter (OTC) or prescription (Rx) painkillers, although there are also a multitude of homeopathic remedies and prevention techniques that involve ingesting nothing at all (like warm compresses on the forehead and|or back of neck, a nap, meditation, etc.). I started getting classic migraines when I was fifteen (about 18 years ago - egad, I've lived more of my life with them than without!). The likelihood of falling prey to them seems to run in families; when I got the first one, my mom knew right away what was going on. (Also, for some reason, if as a child you often got "brain freeze" from icy treats, you're more likely to suffer these kinds of migraines as an adult.)

Then there are "band" migraines (that's what I call them, I don't know if neurologists have a special name for them). A "classic" migraine usually hurts in a vaguely bandlike area of pressure across the forehead and around, like where a hat brim would be. But these others are more like a ladies' headband in placement of the pain, further toward the top of the head and just about following the hairline along the ears and toward the back of the neck. Where a classic migraine tends to be "stabbing" or "throbbing" in nature, a band migraine is, for me, more like a grinding sensation, and always comes with extreme intolerance of bright light (fluorescents are brutal) and sharp noises, and urgent nausea that never resolves into anything.

Then there are the "cluster" migraines. I've had these for a long time too, intermittently; for a long time I called them "Random Sharp Pains" because that's what they were: a sudden sensation similar to what I imagine being stabbed through the skull with an ice pick might feel like, lasting a few seconds, then passing without further effect. But about 12 years ago I learned that they are actually migraines, and when they do their stabbing act, they are actually causing tiny tears in the brain tissue. Contrary to what medical science thought for a long time, brain cells do grow back, so the damage can usually repair itself given time. And as I paid more attention to them, I realized they weren't so random: they only occur (for me) in four places, the parietal and temporal lobes.

I am fortunate to have found a medicine that prevents the cluster migraines, and another that prevents most of the classic and band migraines (and when I can't prevent those, I have another prescription to help, which doesn't get rid of the pain but does make it so I don't care that my head hurts).

But the last one, the one in contention, is the one worrying me the most right now ... it doesn't much feel like a headache, it's more like the feeling after a concussion, a ground-glass-in-the-head sort of sensation, and while I've had concussions in the past, I haven't had one in years ... and a couple of years ago, the first time I was getting these non-aches, I went for a CT-scan and I had a "hypodensate mass in the left posterior temporal lobe" - which is doctorese for "a hole in the language center" of my brain. It was unusual in that such things generally only occur in the elderly; it was downright bizarre that, at the follow-up scan two weeks later, it was gone without any sign of having been there, not even the light scarring that is usually found after such things heal.

On the plus side, with all the migraines, I don't much notice normal headaches anymore - usually one of my unfortunate family members points out (from a safe distance) that I seem a bit grumpy, then I think about it and realize my head hurts a little.