Migraines linked to lesions: Study shows women more susceptible

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Story by Jamie Lampros
(Standard-Examiner correspondent)
Mon, Nov 26, 2012
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Women who have migraines are more likely to develop brain lesions than those who don’t have migraines.

According to a nine-year study done by the Leiden University Medical Center in the Netherlands and published in the Nov. 14 issue of the Journal of the American Medical Association, magnetic resonance imaging showed that

77 percent of women who suffer from the debilitating headaches had an increase in brain lesions, which are tiny ruptures in the arteries that supply blood to the white matter of the brain.

The good news is that the findings also showed that the lesions do not affect memory and brain function — and the number, frequency and severity of headaches do not affect the number of lesions that appear over time.

In the study, researchers looked at whether women and men with migraines had an increase in brain lesions nine years after having an initial MRI. They also looked at whether headache frequency increased the number of lesions and whether or not those lesions were associated with a decline in memory and thinking.

The study found that 112 out of the 145 women in the migraine group had an increase in the number of lesions on the brain nine years after their initial MRI. There was no similar association in men.

Researchers aren’t sure of the exact cause and say more research is needed to determine what that means.

“It’s a good study. The fact that they are seeing brain lesions in migraine sufferers and particularly in women is very noteworthy,” said Cindie Dodenbier, a board-certified nurse practitioner who specializes in pain management at Ogden Clinic Skyline in South Ogden. “I don’t think it’s time for women to panic. It’s a good study but worth looking into more.”

Researchers also said they do not believe there’s reason for alarm based on the study.

Previous research, published in the medical journal Neurology in September 2008, has shown a higher risk of stroke and heart attack for middle-aged women who have migraine headaches preceded by auras.

Because of that, Dodenbier said, women should keep their blood pressure in check, exercise, lose weight and quit smoking. Those factors, she said, can contribute to heart attack and stroke far more often than a migraine.

Migraines affect up to 15 percent of the population, according to the National Headache Foundation. Most people associate migraine with the typical symptoms of intense throbbing on one side of the head, nausea, vomiting and sensitivity to light and sound. Some migraines are preceded by auras that include a blind spot, flashes of light, dizziness or tingling in an arm or leg.

Dodenbier said there are many different types of migraines, including abdominal migraine, chronic migraine, complicated migraine and hormonal migraine.

The causes can vary, and can include foods such as those containing monosodium glutamate and aspartame, smells such as perfume and smoke, changes in barometric pressure, changes in sleep, hormonal changes, stress, sensory changes such as bright lights, certain medications and even a drop in certain brain chemicals.

Dodenbier said women are very susceptible to migraines, especially around their menstrual cycles and sometimes around premenopause and menopause.

“Some women hit menopause and their migraines vanish, while others go into menopause and start having them or they get worse,” she said. “They can be complicated and sometimes it takes time to find the right treatment combination.”

In addition, there are conditions that can mimic a migraine, such as problems with the neck caused by whiplash or other injuries.

“It’s really important to try to figure out the underlying cause so you can treat the migraine correctly, and sometimes it takes time to find the right combination of therapy.”

Treatment options vary, but can include massage therapy, acupuncture, guided imagery such as biofeedback, antidepressants, anti-seizure medications, triptans (medications that abort a headache), caffeine in limited amounts, anti-nausea medications, opiates, antihistamines and Botox.

“The important thing about headaches is to try to figure out the trigger and then to avoid the trigger as much as possible,” Dodenbier said. “Stay well-hydrated, stick to a regular sleep routine, get plenty of exercise and rest — and if you have a headache that is different and unusual, get to your doctor or emergency room right away.

“Most of the time, a headache isn’t anything life-threatening, but it’s better to be safe than sorry.”


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