Concussions and migraines are both poorly understood conditions. In the past, both have been looked at as just bump to the head, or just a headache. However, we’re finding out that concussions are very serious and have way worse side-effects than a simple bump on the head if not handled correctly. A traumatic brain injury (TBI) can lead to damage in the brain that is deemed a concussion if the effects are large enough on the person. There are two connects between concussions and migraines that are interesting on their own and in light of my own experience with migraines.
First off, let’s clarify the different variations of migraines. There are two main categories, Migraines with Aura (MA) and Migraines without Aura (MO). MOs aren’t really important in this discussion because they haven’t been shown to be affected by concussions. However, MAs have been shown to interact with concussions through mechanisms of Aura.
Aura is a general category of symptoms in some MAs. The aura effect includes symptoms of vision like light sensitivity, blind spots, patterns, etc… as well as other symptoms beyond vision like general confusion, inability to comprehend language, extreme sensitivity to touch, dizziness and others. Aura is important in the connection between migraines and concussions because they are both in some portion attributed to spreading depression in neurons in the brain. Spreading depression is referring to the spread of an action potential down a neuron. In a concussion it occurs due to increased ionic flux (charged particles like sodium moving across membrane, depolarization) in neurons due to mechanoporation, which is essentially putting holes in the neuron. Sodium and calcium move in and cause the neuron to fire randomly. MAs have also been well associated with ionic flux, which is where the connection lies. Those who are susceptible to migraines already have been shown to be more responsive to TBIs (concuss easier) and certain mutations leading to migraines with numbness/paralysis on one side of the body (hemiplegic migraine) have also been associated with increased concussion risk. So essentially, MAs and concussions both involve ionic flux, which can serve as a way for concussions to increase migraine risk and vice versa.
I find myself to be an interesting case study in this association. I have a history of migraines in my family, both my mom and dad experience them and other family members. The migraines I experience are with the Aura as well as hemiplegic. Many people have a typical path to their migraine progression. Mine starts with hemiplagia. I will all of a sudden feel oddly light and then one extremity on one side of my body will go numb, my arm or leg partially or fully. This is when I medicate if I can. If it continues, often I will regain feeling in that side and lose it in the other. This is kinda scary because these feelings have been associated with multiple mini strokes in the past, which I don’t want. Regardless, after the numbness I get visuals, including extreme light sensitivity and tunnel visions. This is when I hide out in the basement and prepare for 2-3 days of an extreme headache. The pain follows right after visuals. My migraine then ends in nausea, throwing up releases the pain of the migraine almost completely.
My migraines didn’t start on their own though. In 6th grade, I received a headbutt from a friend right into my right temple extremely hard. We were playing football and we just collided going for a ball. At first my head only hurt a little, but in the next four hours it got so bad I had to go to the nurse, home, basement ASAP. It was the most painful thing, couldn’t do anything but feel the pain and ignore the light. This was the beginning of my migraines which happened a little more than once a month through highschool. But they all but stopped after highschool. I’ve considered that I manage my stress better, cince that caused them in the past, but I still seem to get just as stressed at times. However the mechanoporation offers an interesting explanation. The increased ionic flux from my head injury might have increased my risk for MAs. But over time, as my brain healed up slowly, less and less ionic flux was allowed and my migraines gradually went away. This is an interesting concept because the most important thing with concussions is allowing them time to heal, but it seems my healing process took over 6 years. How can we determine when it’s safe to play if my brain may have taken this long to fully heal one impact? More investigation is needed in the long term healing of concussions to determine how truly bad these are for our health.
A Connection Between Concussions and Migraines and My Own Experience
