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History of Migraine

Migraine is perhaps one of the oldest recognized disorders of the nervous system. Its original name “hemicrania,” is derived from the Greek word hemikrania, meaning half (hemi) of the skull (kranion). Many migraineurs experience headache on half of their head. In ancient times, migraine was thought to be caused by evil spirits, and one treatment was to bore holes in the skull to “release” them.

A bit less abstract, Hippocrates thought there were bad “humors” in the blood and bodily fluids. Vomiting was thought to release the humors, hence with migraineurs often felt better after this occurred. Some treatments involved provoking vomiting for this reason. Another means to release these humors was thorough bloodletting. This was particularly popular in the medieval period, but was used up to the early century. Blood flow, vasodilation on “congestion” became common theory throughout the years for migraine. Probable the best evidence for change in vasomotor activity (blood vessel constriction and dilation) was in the 1950s by Wolff and Graham, who noted dilation during a migraine attack and constriction with certain medications (ergotamines).

Decades later, the relationship between vasomotor activity and migraine remains debated, as many believe they are correlated, but that changes in vascular tone do not actually cause migraine, occurring rather due to the complex wiring during a migraine. Another popular theory has dealt with electrical and chemical changes in the brainstem’s pain center, radiating upwards into the brain. This theory is currently the most popular, and is backed by sophisticated studies, including those with functional imaging. Essentially, the migraine patient can be thought of as someone with a sensitive brain, overreacting to normal sensory stimuli (ie bright lights, loud sounds, motion, smells, etc.). This concept is fitting with the migraine life-cycle and the presence of migraine triggers. It is with this pathophysiologic concept of migraine in mind that HeadAid was created.

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