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 marked 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 people have 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 come right before 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 people 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 knowing 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

  • Medicines, as recommended by your doctor

  • Stress management

You may need to take certain medicines to treat your migraines. These include:

  • Abortive medicines. These are medicines prescribed by your doctor. They act on specific receptors in both the brain and the blood vessels in the head, stopping a headache once it is in progress.

  • Rescue medicines. These are pain relief medicines available over the counter to diminish or stop the headache.

  • Preventive medicines. These are medicines prescribed by your doctor that you take every day to stop severe migraine headaches.

Some headaches may need medical attention right away. This may include a hospital stay, diagnostic testing, or even surgery. Treatment is based on the condition that is causing the headache. Full recovery depends on the type of headache and other health problems you may have.

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 Fireman 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. 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 Fireman Vascular Center, the interventional specialists of the Neuroendovascular Program perform minimally invasive, image-guided treatments for conditions including stroke and cerebral aneurysm. In addition, our specialty-trained radiologists use the latest imaging technologies to provide diagnostic exams for a full range of neurological conditions.
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.

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