DEVELOPING OF HEADACHE: STAGE 3
This is the dilation phase of the headache process. In all three headache types, actual pain occurs as arteries in the forehead, scalp and brain dilate. Fine nerve laments (nerve plexuses), which line the walls of these arteries, are extremely sensitive to being stretched. When the arteries swell and distend, these nerves fairly scream with pain.
At no time does the brain itself experience pain, for it contains no sensory nerves. All intracranial sensitivity exists in the membranes, or meninges, that line the inner wall of the skull.
Tension Headache. Most tension headaches occur as arteries in the forehead, scalp and brain dilate. Other pain signals may be generated by nerve endings located in the contracted muscles of shoulders, neck and scalp. Several hours after the headache begins, these muscles begin to relax and cease to generate further pain signals. But it may be 12 hours before the headband arteries return to normal size and the headache dissipates spontaneously. Throughout the tension headache, blood flow to the head remains constant and unchanged.
Migraine Headaches. Although observations at headache clinics indicate that common migraine may be more painful than the classic variety, from the beginning of Stage 3 on, the headache process is virtually identical for both migraine types.
Once the cerebral blood vessels dilate, the headache begins. Occasionally, the pain is mild and bearable; more often it appears as a throbbing, hammering pain that envelops the eye and nostril on one side of the head.
The pain can become so severe that victims are unable to walk straight, and may bump into furniture. During some attacks, the pain is so disabling that the person becomes incapable of coherent thought. Roughly half of all migraineurs experience nausea and vomiting. Others arc plagued by diarrhea, dizziness, or bouts of hot flashesalternated with shivering spells. It is not unusual to see the arteries pulsating on the scalp while veins on the forehead are also visibly swollen.
The pain may reach back and follow the temporal artery up and over the ear and back to the neck on the afflicted side. Rarely does migraine appear on both sides of the head at once. Gradually, what feels like army boots pounding on the skull gives way to a steady ache. The torment can last from three hours to three days.
Yet in most cases, the headache lasts only until the victim falls asleep. When the migraineur wakes up, the headache is gone. The sufferer may feel weak and washed out and may pass copious amounts of pale urine, but permanent physical damage is rare.
Migraine does not usually return until the supply of norepinephrine has been replenished. This normally guarantees freedom from another attack for at least several days.
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