by Daniel Braum

Migraines typically affect one side of the head and have a pulsating nature. They tend to last from about 4 hours up to several days and are brought on by the vascular narrowing of microscopic blood vessels carrying vital blood into the deep structures of the brain. What causes migraines is not completely known but stress, anxiety, hormones, and even substances such as nicotine can trigger a migraine. The symptoms of a migraine can include nausea, vomiting, sensitivity to light and sound, dizziness, euphoria, and fatigue. There are seven different subclasses of migraines according to "The International Classification of Headache Disorders":

Migraine without Aura- common migraine is a migraine headache that is not accompanied by a visual disturbance or euphoria.

Migraine with Aura- a migraine headache that is accompanied by a visual disturbance or euphoria, but can also be accompanied by motor weakness, difficulty speaking, vertigo, or ringing in the ears.

Childhood Periodic Syndromes- can be a common precursor of migraines and include intense periods of vomiting, abdominal pain and occasional attacks of vertigo.

Retinal Migraine- are accompanied by visual disturbances including blurred vision or blindness in one eye.

Complications of migraine- this describes migraines and/or auras that are unusually long or frequent, and might be associated with a seizure or a brain lesion.

Probable Migraine- Describes when someone has conditions that are characteristic of migraines, yet there is not enough evidence to diagnose the conditions as a migraine.

Chronic Migraine- describes when someone has the conditions that are characteristic of migraines for a greater time interval. The criteria are migraines for 15 or more days a month and for a period of more than 3 months.

Migraines have 4 possible phases associated with an attack, but not all phases are always experienced. In addition, the phases experienced as well as symptoms can vary from one migraine attack to another in the same person.

Prodrome- Occurs anywhere from hours to days before an actual attack, and 40-60% of those who suffer from migraines experience this phase. It may include mood change, irritability, euphoria, depression, fatigue, yawning and excessive sleepiness, food cravings, stiff muscles, dizziness, hot ears, and constipation or diarrhea. Those that experience a Prodrome regularly can use these signs to detect the onset of a migraine.

Aura- Can precede or accompany an attack for the 20-30% of people that experience a migraine with aura. The Aura comprises focal neurological phenomena and can appear gradually over 5-20 minutes. It generally lasts fewer than 60 minutes, and is associated with the start of the headache phase. Sometime the headache phase can be missing entirely, which is known as a silent migraine. Visual Aura is the most common of the neurological events, and is a disturbance of vision consisting of unformed flashes of white or sometimes black light. It can also include blurred or altered vision.

Pain- The headache is typically unilateral, (on one side of the head) throbbing, and moderate to severe pain. It can be aggravated by physical activity, and the onset is usually gradual. This is accompanied by a varying number of other features. Nausea occurs in almost 90 percent of patients, and vomiting occurs in about 30 percent.

Postdrome- The effects of a migraine may continue for up to several days after the headache has ended. Many people experience a sore area where the migraine was, as well as fatigue. Some people also experience impaired thinking or a "hung-over" type of feeling.

Traditional Treatment Options:

There are several different pharmaceutical options for treatment, including Ergomar which works to dilate affected blood vessels that can reach deep into the brain where migraines are thought to originate. The most common treatments are Imitrex, Inderal, Elavil, and Toradol. These drugs are very strong and tend to produce some noticeable side effects. People with infrequent mild migraine headaches that don't interfere with daily activities may choose to self medicate with an over the counter pain reliever such as acetaminophen (Tylenol) or a non steroidal anti-inflammatory drug. (Aspirin/non aspirin) Abortive medications are used in cases when a migraine is more severe, and are different from OTC drugs because instead of relieving pain, they abort headaches by counteracting the cause of the headache- dilation of the temporal arteries.

Medical Marijuana Management:

Medical marijuana provides major relief for many people suffering from migraine headaches. Most that use medical marijuana for migraines do so by smoking it. Smoking is a preferred method of intake because once it is inhaled, the cannabinoids quickly enter the bloodstream and the medical effect can usually be felt within minutes. This can present an issue for a percentage of people who suffer from migraines as inhaled carbon monoxide can intensify the symptoms of the headache. Edibles will not create the same issue, but can take up to 2 hours to fully take effect which is not ideal either. Many people also find that the use of lozenges or tinctures can be more effective because the body absorbs the cannabinoids more quickly when taken sub-lingual than through your stomach lining. Idicas are known to have a more beneficial effect than sativas when treating migraines because sativas tend to increase ocular pressure and can intensify a migraine headache. Indicas that are commonly used for migraine treatment include Sensi Star, O.G. Kush, Bubba Kush, Romulan, and Dark Knight.