Headache/Migraine

Headaches and migraines are common ailments that affect millions of people every day. The causes are many. We will look at some of the most common types:

  • Headache as a result of concussion
  • Migraine
  • Tension headache
  • Cervicogenic headache

Headache after concussion

Symptoms of post-concussive headache (post-concussion headache) vary depending on the type of headache experienced. The most common types of post-concussive headaches include tension headaches and migraine without aura, while cervicogenic headaches are also common in neck injuries such as whiplash. Many of these patients also suffer from fatigue and exhaustion.

Read more about concussion here

Migraine

Migraine headaches may have an aura before or during the headache, and may be experienced as seizures. Auras often involve spontaneous activity in the neurons of the visual cortex, and can cause changes in visual acuity, loss of vision or perception of bright spots or light. The pain is then dull and pulsating, usually on one side of the head. Nausea, vomiting, vomiting, photophobia, and sensitivity to sound are common symptoms. The pain can range from moderate to severe intensity and can reach a disabling level.

Migraines can occur due to various factors such as trauma, hormonal changes, food sensitivities and autonomic dysregulation. In particular, migraines often occur as a result of traumatic head injury or as part of Post Commotio Syndrome.

Genetic influence in the development of migraine is significant. Research indicates that a significant part of the vulnerability to migraine is hereditary. Genetic variations have been observed in ion pumps responsible for regulating sodium and potassium concentrations in neurons. These pumps play a crucial role in maintaining proper neuronal activation.
These genetic factors lead to dysfunction in specific ion channels that control the flow of calcium ions into neurons, and this affects serotonin release in the midbrain. Serotonin is an important regulator of blood vessels and is involved in various pain modulating mechanisms. Reduced serotonin release due to channel dysfunction makes individuals more vulnerable to migraine.

Magnesium also plays an important role, as it blocks excessive activity in calcium channels observed in migraine, and magnesium deficiency has been detected in the cortex of migraine patients.

Cervicogenic headache

Cervicogenic headaches originate in the muscles and deep structures of the neck. The cervical area around the spine contains various tissues that can cause painful and intense localized pain. The causes of these headaches can be whiplash injuries, sports injuries, inflammation of muscles and joints, or irritation of nerves. The pain is often accompanied by limited mobility in the neck, which can result in the formation of fibrous tissue and further reduced mobility. As a result, the pain usually radiates from the neck to the back and sides of the head, as well as to the forehead and the area around or behind the eyes. At this point, attention often turns to the headache, while the pain from the cervical spine is less noticed. Many people tend to focus on the headache and neglect the pain originating from the neck. This type of headache can also cause dizziness.

In cases of cervicogenic headaches, it is important to properly examine and improve eye motor function. Often we observe that neck injuries can have a negative impact on eye movement and the function of the inner ear (balance organ). As there is a close interaction between the eyes, neck and inner ear, it is crucial to evaluate the eye movements and treat any problems, when rehabilitating the neck injuries, that are causing the headaches. Research shows that impaired eye motor function and neck problems often occur simultaneously, and therefore rehabilitating both eye motor function and the neck is effective in reducing symptoms related to both the neck and eyes after neck injuries.

When you experience a whiplash injury, this can lead to disturbances in the body's balance and control system due to disorganized activity in the neck. The ability to activate reflexes in the nervous system that stabilize the deep muscles in the neck can be impaired. In cases of whiplash, there is a disruption in the cooperation between the neck and the eyes, especially when moving at different speeds. This lack of proper control and cooperation between the eyes and the neck has significant consequences for the common symptoms experienced in whiplash injuries.

Read more about whiplash here

Tension headache

Tension headaches are linked to muscle tension, muscle spasms or stress. It is experienced as a tight, squeezing feeling all around the head or on one side. The pain associated with this type of headache is mild to moderate. Tension headaches tend to worsen during the day, and many people experience pain in the evening.

How does the brain come into play?

The brain has an important role in understanding where our body is located in space so that we can react correctly to our surroundings. It does this by using different maps that gather information from our eyes, inner ear, muscles and joints. These maps help us form a coherent perception of where we are in space. We also have maps that control movement. In our brain, there are maps for sensory experiences and maps for movement in the parietal and frontal lobes. These maps should ideally give us the same information at all times. Research shows that people who suffer from migraines have a clear impairment in the connection between the sensory and movement maps. The lack of this connection is believed to be one reason why migraine pain is more intense.

Treatment

Treatment of headaches and migraines can range from simple to complex. It is important to find the main cause of the headache/migraine so that you get the right treatment. Does it stem from the eyes, the balance organ or the muscles and joints in the neck, or does it stem from something else? In many cases, we see that the problem stems from one or more of these systems. Here at the clinic, we have a customized treatment plan for each individual patient, where we target the treatment to where the main cause lies. What you can expect:

  1. Review of medical history
  2. Thorough neurological and physical examination
  3. Test of balance
  4. Video-oculography (Filming of eye motor function)
  5. Review of findings
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