| Basilar migraine or basilar artery migraine as it is | | | | Testing For Basilar Migraine If you present to a |
| sometimes called, is one of those atypical headaches | | | | doctor with the symptoms of basilar migraine, |
| that can have frightening symptoms. This pain is | | | | unfortunately since it mimics a stroke so closely, be |
| unlike usual migraines. The pain is usually severe, | | | | prepared for a bit of a full work up to rule out |
| throbbing at localized at the back of the head. It may | | | | stroke. This most probably will include an MRI or CT |
| be accompanied by severe vertigo (the sense that | | | | of the brain right away and possibly an MRA to look |
| the room is spinning), difficulty walking and most | | | | at the arteries of the brain. Again this would not only |
| commonly, visual disturbances. | | | | find a stroke but also find an aneurysm. A full |
| Now what is meant by visual disturbances? Well, just | | | | examination including some testing for vertigo and |
| about anything from blurry vision to blindness. This is | | | | hearing (if necessary) should be performed. |
| caused by the fact that the basilar artery, where the | | | | If the doctor is suspicious about possible seizures |
| problem is happening, is located in the back of the | | | | (they sometimes present with vertigo and headache) |
| head. This artery feeds blood and oxygen to the | | | | then an EEG is necessary. This is just a study to look |
| back of the brain where the visual centers are | | | | at the electrical waves in the brain and involves |
| located..if you have a problem in that area it definitely | | | | wearing some scalp electrodes and getting your hair |
| affects your vision. | | | | messed up! |
| Other common migraine headache symptoms may | | | | Treatment Once a stroke has been ruled out, |
| also occur such as nausea, vomiting and having the | | | | treatment is pretty straight forward. If the headache |
| light and sounds bother you. Rarer symptoms are | | | | is disabling and occurs a couple of times a month, |
| jerking movements of the eyes, ringing in the ears | | | | then you need to be on daily therapy for awhile, |
| and loss of consciousness. Severe vertigo is quite | | | | perhaps a few months to a year. |
| common and can be disabling. | | | | While many preventative medications for migraine are |
| Why Is This Serious? A basilar migraine can increase | | | | familiar to most headache sufferers, the drug of |
| the risk of stroke. Although a neurovascular condition | | | | choice for this type of headache is verapamil taken |
| like all other migraines, one of the problems is that | | | | once or twice a day. If you cannot take this |
| aneurysms (an out-pouching of the artery) may | | | | medication, a beta-blocker such as Inderal is a good |
| occur in this area. | | | | choice also. |
| If caught, aneurysms are generally followed with | | | | If an attack does occur, most people can manage it |
| more imaging such as a CT angiogram which gets a | | | | well with a small dose of a pain killer. Many people |
| much better look at it. Surgery is recommended to | | | | also wonder why they cannot take their usual |
| "clip" it when it gets to a certain size. For cerebral | | | | medications for migraine but unfortunately, all triptans |
| aneurysms the limit is usually 10mm although some | | | | such as Imitrex, are contra-indicated for this. |
| surgeons have told me they will do the procedure on | | | | Take heart! New treatments and research are always |
| a smaller one if the patient has neurological | | | | coming up. This issue may change in the future with |
| symptoms. | | | | more research. |