Conditions & Treatments

Vascular Headaches and Migraines

This throbbing type of headache is distinguished by the fact that symptoms other than pain occur with the headache.

Migraine Headaches

What are migraine headaches?

This throbbing type of headache is distinguished by the fact that symptoms other than pain occur with the headache. Nausea and vomiting, lightheadedness, sensitivity to light (photophobia), and other visual disturbances are common migraine symptoms.

Migraines are also unique in that they have distinct phases. Not all individuals experience each phase, however. The phases of a migraine headache may include:

  • Premonition phase. A change in mood or behavior that may occur hours or days before the headache.

  • Aura phase. A group of visual, sensory, or motor symptoms that immediately precede the headache. Examples include hallucinations, numbness, changes in speech, and muscle weakness.

  • Headache phase. Period during the actual headache. Throbbing pain occurs on one or both sides of the head. Sensitivity to light and motion is common, as are depression, fatigue, and anxiety.

  • Headache resolution phase. Pain lessens during this phase, but may be replaced with fatigue, irritability, and difficulty concentrating. Some individuals feel refreshed after an attack, while others do not.

What are the most common types of migraines?

Migraine classification helps to guide treatment. The categories below help to narrow down the classification process.

  • Migraine without aura. This more common type of migraine does not include an aura phase (symptoms that come just before the headache).

  • Migraine with aura. Fewer migraine sufferers have this type of migraine, which is preceded by aura symptoms, such as a flashing light or zigzag lines. These symptoms usually appear within 30 minutes before an attack.

How are migraines diagnosed?

Migraine headaches are diagnosed primarily based on reported symptoms, but a thorough medical exam, which may include other tests or procedures, may be used to rule out underlying diseases or conditions.

Tracking and sharing information about your headache with your doctor helps with the process of making an accurate diagnosis. Consider writing down the following information to take to your medical appointment:

  • Time of day when your headaches occur

  • Specific location of your headaches

  • How your headaches feel

  • How long your headaches last

  • Any changes in behavior or personality

  • Effect of changes in position or activities on the headache

  • Effect of headaches on sleep patterns

  • Information about stress in your life

  • Information about any head trauma

Diagnostic tests that may be used to confirm a migraine diagnosis include computerized tomography (CT) scans, magnetic resonance imagining (MRI), and spinal tap (lumbar puncture). These tests help to rule out other problems, such as tumors, infection, or blood vessel irregularities that may cause migraine-like symptoms.

What is the treatment for migraines?

Specific treatment for headaches will be determined by your doctor based on:

  • Your age, overall health, and medical history

  • Type of migraine

  • Severity and frequency of the migraine

  • Your tolerance for specific medications, procedures, or therapies

  • Your opinion or preference

The ultimate goal of treatment is to stop migraines from occurring. Adequate management depends on the accurate identification of the type of headache and may include:

  • Avoiding known triggers, such as certain foods and beverages, lack of sleep, and fasting

  • Changing eating habits

  • Exercise

  • Resting in a quiet, dark environment

  • Medications, as recommended by your doctor

  • Stress management

Migraine headaches may require specific medication management including:

  • Abortive medications. Medications, prescribed by your doctor, that act on specific receptors in both the brain and the blood vessels in the head, stopping a headache once it is in progress.

  • Rescue medications. Medications purchased over the counter, such as analgesics (pain relievers), to diminish or stop the headache.

  • Preventive medications. Medications prescribed by your doctor that are taken daily to¬†suppress the onset of severe migraine headaches.

Some headaches may require immediate medical attention, including hospitalization for observation, diagnostic testing, or even surgery. Treatment is individualized, depending on the underlying condition causing the headache. Full recovery depends on the type of headache and other medical problems that may be present.

Treatment Programs


Massachusetts General Hospital understands that a variety of factors influence patients' health care decisions. That's just one reason why we're dedicated to ensuring patients understand their diagnosis and treatment options. Because a single option might not serve all patients, we offer a wide range of coordinated treatments and related services across the hospital. Patients should consult with their primary care doctor or other qualified health care provider for medical advice and diagnosis information.

Select a treatment program for more information:



Imaging

  • Vascular Imaging and Intervention
    Working as part of the Vascular Center, the interventional vascular specialists of the Vascular Imaging and Intervention Program at Massachusetts General Hospital Imaging perform minimally invasive, image-guided treatments for conditions including stroke and peripheral vascular disease. These same interventionalists also use minimally invasive techniques to treat non-vascular conditions including uterine fibroids and certain kinds of cancer. In addition, our specialty-trained radiologists use the latest imaging technologies to provide diagnostic exams for a full range of vascular conditions.
  • Neuroendovascular Program
    Working as part of the Vascular Center, the interventional specialists of the Neuroendovascular Program perform minimally invasive, image-guided treatments for conditions including stroke and cerebral aneurysm. These same interventionalists also use minimally invasive techniques to treat non-vascular conditions including herniated disc and vertebral fractures. In addition, our specialty-trained radiologists use the latest imaging technologies to provide diagnostic exams for a full range of neurological conditions.
MassGeneral Hospital for Children

  • Pediatric Speech, Language and Swallowing Disorders
    The Department of Speech, Language and Swallowing Disorders and Reading Disabilities at MassGeneral Hospital for Children diagnoses and treats children and adolescents with speech, language, reading and swallowing impairments and disorders.
Department of Neurology

  • Neuro-ophthalmology Service
    The Neuro-ophthalmology Service at Massachusetts General Hospital provides expert evaluation, diagnosis and treatment for patients who have vision problems with a neurologic basis.
Obstetrics and Gynecology

  • Midlife Women's Health Center
    The Massachusetts General Hospital Midlife Women’s Health Center brings together experts from more than 15 specialties to improve, promote and advance health care for women at menopause and beyond through research, collaboration and education.

The following related clinical trials and research studies are currently seeking participants at Massachusetts General Hospital. Search for clinical trials and studies in another area of interest.

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