Migraine Headache Theory

There are various theories exist regarding the mechanisms of origin of migraine headache. One of such theories is the vascular theory which proposes that the intracranial vasoconstriction causes ischemia, which results in the aura preceding the migraine. The subsequent rebound vasodilation causes the migraine headache. The theory was based on the observation that during a migraine attack the extracranial vessels become pulsatile and distended. However, this theory was disputed as it couldn’t explain the facts that not all the individuals who suffer from migraine have a pulsatile quality of headache as well as some patients do not experience the aura. Also, the vascular theory was not able to explain the efficacy of certain medications that is used to treat …show more content…
This theory suggests that a multifaceted succession of neural and vascular activities commences migraine. At the normal state, even in the absence of a headache the cerebral cortex, mainly the occipital cortex of a migraineur’s brain is in a state of hyper excitability. These findings are proven in studies involving transcranial magnetic stimulation with functional magnetic resonance imaging (MRI). This finding justifies the distinctive vulnerability of the brain of patients with migraine to headaches.
The cortical spreading depression (CSD) theory defines the process involving in MA. CSD is a precise ripple of neuronal excitation in the cortical gray matter that sweeps from its starting point at the rate of two- six millimeters (mm)/ minute (min). This cellular depolarization produces the aura phases and thereby triggers trigeminal fibers resulting in the phase of headache. The discharge of potassium or the excitatory amino acid glutamate from neural tissue causes depolarization of the nearby tissues leading to the discharge of more neurotransmitters thereby disseminating