Most people have headaches at times, although I occasionally meet someone that has never had a headache in their life.  Certainly these individuals are abnormal, but in a good way.  Although headaches per se are not normal, it is common for them to occur at least on occasion.

For people that experience severe or frequent headaches, however, hope for finding a solution is always welcome news.

As always, this column is not a replacement for a physician evaluation.  If you have a headache that is worse than ever, or does not respond to normal avenues of relief, you should seek immediate emergency care.  Occasionally headaches can be a sign of serious threatening health problems.

I regularly get updates on headache related research.  It seems that nearly every week a new study is published that delves into the effects of various aspects of migraine headaches.

As techniques and equipment become more sophisticated in the ability to observe anatomical variants and functional aspects of our bodies, new discoveries present hope for resolving headaches.

Recently there have been several announcements about anatomical discoveries that may play a role in migraine headaches.

According to a new study by researchers in the Perelman School of Medicine at the University of Pennsylvania, people that frequently experience migraines were found to have variations in the anatomical structure of arteries in the brain.  The migraine patients were more likely to have interrupted or incomplete arterial circuits in the brain.

Keep in mind that these findings reflect a relative difference between migraine patients and those that do not experience migraine.  For example, 71% of patients that have visual disturbances with migraine had incomplete blood vessel structures, compared to 67% of migraine patients without visual disturbances.  To better understand the significance of these numbers, consider that 51% of people without migraine headaches had the anatomical aberrations.  That means that half of the people tested had the observed anatomical variations but did not have migraines.

From this it would be reasonable to conclude that the structure of the brain’s arterial connections appears to play a role in whether people get migraines and whether they have visual disturbances, but there is obviously much more involved. 

This study illustrates some of the complexity involved with headache treatment.

There are so many theories in the medical literature about the causes and origins of migraine headaches that it would be understandable to conclude that no one actually knows what causes them.

Routinely a researcher will find and publish another clue to the puzzle, but no one has successfully fit all the clues together.

There are a number of medications used to prevent or interrupt a migraine once it has begun.

In general terms the prescription drugs used in an attempt to prevent migraines are either anti-seizure drugs or beta-blockers.  The drugs are used off-label, meaning that they have not been approved by the FDA for the specific condition of migraines, but are allowed to be used for this as guided by the discretion of the prescribing doctor.

A recent study published earlier this year in the Journal of General Internal Medicine disclosed that the drugs did not differ in their effectiveness greatly, but did vary in their overall side effects.  The anti-seizure medications were more likely to cause side effects that were not tolerated.

The drugs were considered beneficial if they reduced the incidence of migraines by at least fifty percent in at least 20-40% of the patients treated.  If you think about those numbers, it is easy to realize that those drugs are not really very effective for most people.  Up to 80% of the patients failed to reduce their headaches by one half.

Although the medications can be helpful for some patients there is still a lot of room for improvement in the understanding and successful treatment of migraines.

For some patients, the answer may be found in alternative medical solutions.

In our clinic we routinely help patients resolve headache issues, including those with migraines.  We never use drugs in the process.  We obviously never change the actual anatomical structure of the blood vessels in their brain.

In the ongoing search for answers to migraines, it pays to consider all alternatives.