What Are Migraines?

so today we're gonna talk about migraines migraines can affect up to 12% of the population women being more affected than men and most people will tell you that a migraine is a headache however those who get migraines will probably tell you there's a little bit more to it than just simply a headache and we are gonna go into that we're gonna talk about multiple phases that are incorporated into a migraine and there's also multiple types of migraines and to help us with this story we're obviously going to use some anatomical awesomeness to help us describe migraines so let's get to it so let's define an actual migraine a migraine is a complex neurological disorder that can be divided into four different phases we're gonna talk about each one of these phases as they apply to a migraine the first phase is called the pre monetary phase this can start up to 72 hours before the actual headache and people will experience symptoms like fatigue photophobia which is light sensitivity irritability sometimes depression they can also notice that they might yawn more also have food cravings and even stiffness and certain muscles especially in the neck and so the next question might be what is actually starting this phase or causing this phase and they believe it's an actual alteration in homeostasis and if you talk about homeostasis or keeping the body in balance in equilibrium you have to talk about the structure called the hypothalamus so the hypothalamus is in the central core of the brain and you can see I'm tracing it with the probe here now some other structures you may have heard about are something like this the pituitary gland which is below the hypothalamus and over here you can see this expansion referred to as the brainstem if you go follow it down that becomes the spinal cord but again we're coming up to this structure in the central core known as the hypothalamus and this thing again gets involved in homeostasis so how does it get involved in homeostasis well one it's the principle autonomic center of the brain so therefore it takes care of certain parts of the nervous system that you don't have to think about also gets involved in regulating and releasing hormones this is probably why women are a little bit more affected with migraines than men also gets involved in regulating certain behaviors also food cravings so thirst and hunger mechanisms and even gets involved in regulating body temperature so if we kind of just take a step back and we look at okay this is what the hypothalamus is involved in and we compare that to the pre monitor symptoms that we talked about things like fatigue the food cravings you can see that relationship between the symptoms and what the hypothalamus actually does so are there things that a person with a migraine can do that influences if they get a migraine or not or possibly triggers a migraine and the answer is yes the data has shown that people with migraines their brain tends to be a little bit more sensitive to certain environmental stimuli and they have gathered a whole bunch of data on certain environmental stimuli that are potential migraine triggers and this can be quite the long list so buckle up for this they think that some of these triggers are emotional stress hormones not eating weather sleep disturbances even odors neck pain alcohol bright lights smoke certain types of foods even exercise and even sexual activity that last one does kind of suck but luckily that list is from most common to least common and the study that we're quoting here only 5% of people reported that sex was the trigger so you can all probably still participate in safe consensual coitus so moving on so why do we care about all of this information in the pre mana Tory phase well remember it can start up to 72 hours prior to the headache and if you can get out ahead and start treatment before the headache even starts the outcomes are much better so a lot of times when a patient comes into the clinic with me and I'll talk to them about their migraine I'll ask them if they can trace or track the previous three days specifically the types of foods they were eating what was their mood like did they have any of these symptoms what were their sleep patterns like and if they can get this information it can be useful for future migraines now the problem is who doesn't yawn everyone smile who doesn't have some food cravings so that can be challenging but with enough information a lot of times these migraine patients can actually get enough information to find with their triggers and what their symptoms are in this premonitory phase the next phase of a migraine is the aura phase only about a third of people with migraines experience this phase and what is in aura and aura is a fully reversible neurological symptom and there's four types of auras that you typically will see in a migraine the first and most common is the actual visual aura which is spotted or blurred vision sometimes like little zigzag lines in there you can also get a sensory aura which is tingling on one side of the body typically in the upper limb or the side of the face you can get a language aura which is difficulty with wording and speech and even a motor aura which is weakness on one side of the body again you'll sometimes see that in the upper limb or on the side of the face so what is responsible for the aura phase the going theory are going hypothesis is there's this thing called cortical spreading depression what is cortical spreading depression well let's break down the term cortical refers to cortex and in this case we're going to use the brain to help us with this so if you orient yourself to the brain what I'm tracing here is called the cerebrum and the outside surface of the cerebrum is referred to as the cerebral cortex and that can kind of give us the idea of cortical in the cortical spreading depression so we're referring to the outside surface of the cerebrum called the cerebral cortex now the spreading depression what do they mean by that well they believe that there is this depression of neurons in other words neurons depolarizing which is neurons firing off that spreads throughout the cerebral cortex and think of it almost like a drop of water and upon that ripple effect and because of this spreading depression the neurons tend to stay depolarize which is a neuron fired off before it recharges or repolarizes longer than it normally would and they believe this is responsible for the aura symptoms that we just previously mentioned now some people might say okay well what about the people who don't get the aura and the answer is they think it may be occurring this cortical spreading depression that is in areas of the brain that aren't under conscious awareness and so people may still be getting this cortical spreading depression who don't have the aura they just might not be noticing it finally we're on to the third stage of a migraine which is the actual headache phase now this is characterized by a pulsatile throbbing characteristic that tends to be unilateral some patients will get it on both sides of the head and even on the back of the head but most commonly it's one-sided now a lot of patients will also experience nausea vomiting photophobia which is light sensitivity photophobia sound sensitivity and even some people get sensitive to smells few people will get this thing called cutaneous allodynia which is sensitivity to touch like the skin just gets hypersensitive and just even touching a certain area of the skin will cause pain now what is the cause of this now we got to do our step by step approach and the pre monetary phase and that cortical spreading depression is thought to enhance or activate this trigeminal vascular system now some of you may have heard of this thing called the trigeminal nerve and this nerve gets activated in this trigeminal vascular system and this is going to be the cause of the pain now the trigeminal nerve why is it called the trigeminal nerve well three tri means three there's three branches that branch out of the skull coming off the brainstem and flare out on flare out onto the face so one part of the branch goes to the forehead and around the eye and that's called the ophthalmic division of the trigeminal nerve the other around the cheek is called the maxillary division and the third is called the mandibular division this nerve is sometimes nicknamed the great sensory nerve of the face because everywhere you touch on your face is brought in to the brain through that trigeminal nerve now that's important for certain locations of the migraine but there's some internal structures that we actually have to talk about that play a key role in the pain of a migraine okay so the internal structure that we want to show that the trigeminal nerve also controls is this stuff called the dura mater which I'm pinching here the dura is a connective tissue structure that surrounds the brain and it does have sensation and specifically it can sense pain and when the trigeminal nerve gets activated during a migraine it can sensitize the nociceptors in this tissue which are pain receptors and that signal will then come in to the brain and actually detect pain here before we go into more detail I just want to show you how this is wrapped together if I remove the skull here you can see how madura surrounds the outside of the brain as I pull the brain out of here so now that we know the origin of the pain coming in from the dura through the trigeminal nerve into the brain we have to kind of describe okay well why do I feel pain around the eye or the forehead or in some people in the back of the head when the stimulus is essentially coming from inside on that tissue called the dura well that's a story of referred pain and to describe referred pain we have to describe neurons converging in similar places of the brain so for example if I have a sensory neuron on my forehead and a neuron from the dura going into the same area of the brain and converging on a similar nucleus inside the brain that sometimes tricks the brain into thinking oh the pains coming from here even though the stimulus came from a different structure and because those converge on the same area that can give you areas of pain say in the forehead or the back of the head on these converging neurons and that gives you an idea of why you could have different locations of pain from the migraine so finally Ritz the last phase of a migraine the last phase of a migraine is called the post drum phase and that is essentially lingering symptoms from the migraine now migraines can be debilitating partly because it just hurts to do anything like turn your head sneeze cough and things of that nature and the next day after a migraine a lot of people will realize oh I turn and I had pain I sneezed I had pain in that same area and the reason for that is something called sensitization the nerve that we talked about the trigeminal nerve in those tissues those sensory fibers are nociceptors essentially get sensitized to stimuli that normally wouldn't cause pain and again that's why you turn your head it can hurt or you sneeze and it can hurt now that typically goes away over the next day or so but that's why you get this fourth and final phase of a migrant called the post Rome so hopefully that gives you guys an idea or at least more details about how migraines work let us know if you have any questions or comments below and we'll see you next time you [Music]

Channel: Institute of Human Anatomy

Views: 1,980,013

Rating: 4.9626803 out of 5

Keywords: institute of human anatomy, institute of human anatomy tiktok, migraines, migraine, what is a migraine, what are migraines, migraine headache, what is a migraine headache, what is migraine aura, what is a migraine exactly, the science behind migraines, migraines with aura, migraines and headaches, headache, migraine headache symptoms, migraine headaches, what is the difference between a headache and a migraine, what is the cause of migraines, gamers migraine, trigeminal nerve, ioha

Id: MVBNZoEzD1k

Length: 11min 6sec (666 seconds)

Published: Fri Feb 21 2020

Reddit Comments

[u/spicypanda97]

So do we NEED dura mater? I mean, mine seems a little sensitive so I'd like to exchange it or possibly get a refund? Who do I talk to about that?

[u/TurdQueen]

I think if you sprinkle lavendar essential oil on a brain, then hand out pieces of brain for people to take and plant at home to dance around, you can cure headaches.

Pretty sure that's what Gwyneth Paltrow's dog's therapist's son did, and he hasn't had a headache since!

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Thanks for this! Finally a scientific explanation that can combat ^ stupid shit.

[u/GirthyGainz]

Very cool, now if only we could stop them.

[u/GamerRade]

That's not someone dropping a piano on my head. Fake news.

[u/Miss_ChanandelerBong]

The good ole hypothalamus, responsible for the four F's: fighting, fleeing, feeding, and mating.

It's an oldie but a goodie.

Also plays a role in a bunch of other things like body temperature and sleep regulation but those don't fit as nicely.

This is a really nice video, thank you for posting!

[u/beets_bears_bubblegm]

He could take my migraine away any day... (I mean probably not unless he was made of Zolmitriptan but I still think he’s cute)

[u/crafternoondelight]

K but is that a real brain and also is that a cadaver behind him?!?

[u/NotAFrench]

I would love to know how migraines could be related to tooth pain though

[u/galermom]

Fascinating but is that a human cadaver in the background??? 😳