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Saturday, 23 November 2013

Basilar Migraines - The Symptoms, Causes and Risk Factors

I. Basilar artery headache (BAM) is a rare form of migraine with aura. Researchers suspected that basilar  migraine had its start in the basilar artery at the brainstem or base of the brain in the back of the head, affecting both hemispheres of the brain at the same time.

II. Symptoms
Each aura symptom may last between five and 60 minutes and starting on one side of the head and gradually spreading and intensifying.
1. Dizziness
2. Double vision
3. Loss of balance
4. Confusion
5. Slurred speech
6. Hearing changes 
7. Body tingling
8. Temporary blindness
9. Etc.

III. Causes and Risk facts
A. Causes
1. Alcohol consumption
There are some reported that Alcoholic drinks are a migraine trigger in about one third of patients with migraine in retrospective studies on trigger factors, but some researchers suggested that a relationship between the intake of alcohol and the migraine attack is not clear, a small dose of alcohol is not contraindicated either for enjoyment or its protective effect on cardiovascular disease.

2. Stress
Stress can have an impact on one’s mental and physical well-being, including migraine headache. Stress describes a negative concept, life events, and concomitant psychosomatic illnesses should be considered important when evaluating individuals with migraine, and gender aspects need to be taken into account(B.A.6)

3. Weather
 In the study 4039 visits for migraines (ICD-9: 346) that occurred at an Ottawa hospital between 1993 and 2000. Meteorological conditions using hourly readings from a fixed-site monitoring station, indicated  that ER visits for migraines are related to weather conditions occurring within the 24 hours preceding presentation.(3)

4. Certain medications
Overuse of acute migraine medications can lead to the development of chronic migraine, depending upon within-person characteristics (eg, headache frequency), class of drug, and frequency of medication use.(4)

5. Emotional stress, sunlight or bright light, sleep deprivation, and hunger
In a study of One thousand six hundred and seventy-nine students aged 11-18 years conducted by University of Beni. The overall prevalence of headache was 19.5%, the prevalence of migraine was 13.5% as a result of emotional stress, sunlight or bright light, sleep deprivation, and hunger(5)

6. Female hormonal changes
Some researchers suggested that women who use hormonal contraceptives and hormone replacement treatment may increase the risk of migraine occurrence.(B.A.4)

7.  Alcohol, Bright lights, Sleep, Menstruation, Perfume, etc.
Beside the causes above, out of 126/179 replies, other factors triggering migraine attack include too much work (under the stress category 54/64), reflected sunlight (under the light category 35/44), too little sleep (under the sleep category 19/24), red wine (under the alcohol category 20/22), passive smoking (under the smoke category 11/11), menstruation (under the menstruation or break from the pill category 12/14) and perfume (under the fumes/heavy scents category 12/15). Hormones, light and stress were reported to cause at least 50 % of MA attacks in 62%, 47% and 42% of participants, respectively. No participants reported alcohol to be the trigger of 50% or more of their attacks. In the groups of participants with "light", "fumes/heavy scents", "smoke" or "physical effort" as triggers, nearly all patients reported that an exposure time to the trigger of less than 3 hours (90-100% of patients) was necessary to trigger an attack and a latency to onset of attack of less than 3 hours (90-100% of patients) in the study conducted by University of Copenhagen and Glostrup Hospital, Denmark J. (B.A.11)

8. Caffeine withdrawal
Over consumption of caffeine  and caffeine withdrawal can causes migraine-like caffeine withdrawal headaches. In the study conducted by Meir General Hospital, Sapir Medical Centre, indicated that Children and adolescents with high daily caffeine consumption in the form of cola drinks may suffer from caffeine-induced daily headache. Gradual withdrawal can be achieved without withdrawal headache and with complete disappearance of the induced chronic daily headache.(8)

9. Consumption of nitrates found in food
Nitric oxide (NO), a free radical is a very important molecule in the regulation of cerebral and extra cerebral cranial blood flow, rterial diameters and nociceptive processing, in a very small dose. Glyceryl trinitrate (GTN), a pro-drug for NO, causes headache in normal volunteers and a so called delayed headache that fulfils criteria for migraine without aura in migraine sufferers(B.A.11)

10. Physical over-exertion
Intensive exercise can increase risk of basilar artery headache. There is a case of a 51-year-old woman who suffered from a sudden attack of throbbing headache in the parieto-temporal region, accompanied by nausea, after 20 minutes of swimming practice in a pool. The headache disappeared after about 3 hours of bed rest. However, soon after she began to practice swimming in the pool a few days later, throbbing headache in the same region recurred(10)



11. Altitude 
Human are born to adapt when exposure to high attitude, but when the mechanisms fail, depending on the rate of ascent and the altitude some may be experience acute mountain sickness (AMS) with headache as its predominant symptom(11)

12. Menstrual Migraine
Menstrual Migraine is caused by fluctuation of the levels of estrogen and progesterone in a woman menstrual cycle, it can be treated by phytoestrogens without stimulation of the endometrium, with decreased risk with long-term use.(B.A.10)

13. Etc.

B. Risk factors 
1. Gender
Significant sex differences exist in migraine and other headache disorders, 75% of all migraine sufferers are women, it may be the result of menstrual cycle and pregnancy causes of the fluctuations of female hormones.

2. Age
Migraine headache migraine affects population of all age, but children with the chronic disorder eventually will see the disorder either disappear or transit to mild-type headaches, when they grow into adulthood.

3. Family history

If one the family member of the direct family has experienced headache migraine, the risk of the same disease of the other members increased by 75%.

4. Etc.
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Sources
(II.2) http://www.ncbi.nlm.nih.gov/pubmed/21797862
(8) http://www.ncbi.nlm.nih.gov/pubmed/12780761
(10) http://www.ncbi.nlm.nih.gov/pubmed?term=migraine%20and%20intense%20exercise
(3) http://www.ncbi.nlm.nih.gov/pubmed/16412153
(11) http://www.ncbi.nlm.nih.gov/pubmed/17341172
(5) http://www.ncbi.nlm.nih.gov/pubmed/20946430
(4) http://www.ncbi.nlm.nih.gov/pubmed/19586594
(B.A.4) http://www.ncbi.nlm.nih.gov/pubmed/22367631
(B.A.6) http://www.ncbi.nlm.nih.gov/pubmed/21668386
(B.A.10) http://www.ncbi.nlm.nih.gov/pubmed?term=soy%20and%20menstrual%20migraine
(B.A.11) http://www.ncbi.nlm.nih.gov/pubmed/20847084