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Last updated: Wed, Jun 28, 2017
Epidemiological data show that in Western countries about 66% of people suffer from headache at some point in their lives, and 14% suffer from migraines.1 Headaches are most common in the teen and early adult years, then become less common.
Migraine headaches without “aura” seem to be the result of a problem with certain areas of the brain stem. Imaging studies have shown increased blood flow in these areas during migraine attacks. These irregularities in the brain stem continue even after the migraine symptoms have been relieved with the drug sumatriptan, so researchers believe that the brain stem irregularities are part of the process that causes the migraines.
At least 20% of migraine patients experience neurological symptoms, including visual aura, before a migraine attack. An abnormal pattern of brain waves called cortical spreading depression (CSD) may be responsible for these symptoms. CSD in turn is associated with changes in blood flow in the brain. Researchers believe that the neurological symptoms that these patients suffer are also the result of irregularities in the brain stem.2
Other brain imaging studies have shown that areas of the hypothalamus are unusually active during cluster headache. Electrical stimulation of this area of the brain has been helpful in relieving this type of headache.3
A study that followed a large number of participants in Norway over eleven years found that those with less education and low “social class” were more likely to develop frequent or chronic headaches. Men with low income were more likely to develop migraine and non-migraine headaches than were men with more income.4
A similar study in the U.K. found that children who suffered from headache were more likely to be depressed, to have a family member with a psychiatric problem, and to have a mother with a severe chronic illness.5
Studies have found evidence that there is a genetic predisposition for migraine with or without aura, for chronic tension headache, and for cluster headache.6
People with migraine with aura have a higher risk for cardiovascular disease and stroke. People with chronic headache are more likely than those without to smoke, to have high blood pressure, high body mass index, diabetes, and high cholesterol intake.7