Migraines: The Vascular Backstory

Blood Vessel

In the past, it was thought that migraines were simply a vascular or blood flow problem. There was even a working vascular theory thought to explain why people would develop these headaches lasting days at a time. During a migraine attack, it was observed in the 1940’s and 50’s that blood vessels would seem to pulsate and enlarge. Medications that act on constricting blood vessels have also been shown to help improve headaches while some medications that are known to cause dilation of blood vessels can trigger a headache attack. For these reasons, it was perceived for many years that migraines were primarily a vascular problem.

However, we now know that the explanation for migraines is a much more complex issue. Due to advances in imaging studies, we can now verify that vasodilation is not the underlying process during a migraine onset. Migraines can occur absent of any prior dilation of blood vessels. With this said, it is still likely that blood vessels do still play a part in migraines, but with a more relegated role. It is a complicated and intricate system where the brain, blood vessels, and inflammation all intertwine to contribute to the migraine process.  

The main takeaway here is we are still learning to understand more about what is occurring in the body. There is not one direct explanation for the migraine mechanism. It is an extraordinarily complex process that involves multiple systems in the body. Treatments can act on multiple systems including the blood vessels that may play a role in their onset. To learn more about these other systems, continue to check out our blog.

Dr. Sharisse Stephenson Dr. Stephenson is a Neurologist and a Board Certified Headache Specialist and Brain Injury Medicine Specialist. She has postgraduate training in neurological disorders and stroke management from Tufts University in Boston.

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