Migraine: Symptoms, Causes and Treatment
You are in the middle of a meeting. The lights suddenly feel too bright. Your colleague's voice is a little too loud. There is a dull throb starting behind one eye, and you already know where this is going. Someone says, "It's just stress. Drink some water." If this sounds familiar, this article is for you. I am Dr Hardik Rajyaguru, a neurosurgeon. In my clinic, I meet people every week who have put up with these headaches for years, because everyone told them it was "just a headache." It is not. It is migraine , and it is very treatable. Let me explain it the way I would to a friend. In short: A migraine is a headache caused by a problem in the brain's pain system, not just by stress, weak eyes or gas. It brings throbbing pain, usually on one side of the head, with nausea and sensitivity to light and sound. An attack lasts 4 to 72 hours if untreated. Migraine can be treated with the right medicine, taken early, and with a few daily habits. Key facts at a glance India: about 1 in 4 adults had migraine in the past year. Two big community surveys found 25.2% in Karnataka (south) and 26.3% in Delhi and the National Capital Region (north). World: about 1 in 9 people (11.6%), pooled from 302 community studies with over 6 million people. India's rate is more than double. Women are affected more: about 2 to 3 times as often as men in the Indian surveys, and about twice as often worldwide. Migraine is the second leading cause of years lived with disability worldwide. In India, headache disorders are the second biggest cause of lost healthy life among brain and nerve diseases, after stroke. Most migraines do not need a brain scan . A scan is for warning signs. Taking painkillers too often can cause daily headache. Is it a migraine? A quick self-check This is not a diagnosis, only a way to know whether it is time to talk to a doctor. Think about your usual bad headaches. How many of these sound like you? The pain throbs or pulses , and it is often on one side . You feel sick, or you vomit . Light or sound feels unbearable, and you want a dark, quiet room. Without treatment, it lasts hours, sometimes up to 3 days . Before it starts you may notice warning signs : mood change, food cravings, yawning, a stiff neck, or flashing lights and zig-zag lines. If two or more feel familiar, please do not just live with it. Keep a headache diary for a few weeks and bring it to a doctor. A normal brain scan does not rule migraine out, as you will see below. What is a migraine? A migraine is a brain condition that causes repeated, often severe headaches. It is not just a bad headache. In a migraine, the nerves that carry pain from the head become over-active. A chemical messenger called CGRP is involved in this pain. Genes also play a part. If your parents or siblings have migraine, you are more likely to have it too. Here is something many patients do not know: the brain itself cannot feel pain. The pain comes from the nerves and blood vessels around it. This is also why a brain scan is often normal in a person with terrible migraines. A normal scan does not mean "nothing is wrong." It means the brain looks normal, but its pain system is behaving badly. How common is migraine in India and the world? Very common, and more common in India than the world average. If it feels like everyone around you gets these headaches, you are not imagining it. India. Two large door-to-door surveys, using the same method, give almost the same answer. In Karnataka (south India), 25.2% of adults had migraine in the past year. In Delhi and the National Capital Region (north India), it was 26.3%. Among women it was 35.7%, and among men 15.1%. The researchers argue that these figures can reasonably be applied to the whole of India. Earlier Indian studies had given conflicting results, which is why the northern study was needed. World. A review of 302 community studies found that 11.6% of people worldwide have migraine. By region: Asia 10.1%, Europe 11.4%, North America 9.7%, Africa 10.4%, and Central and South America 16.4%. It is more common in women (13.8%) than men (6.9%). A newer analysis of global data found that the share of people with migraine has stayed about the same since 1990, but the years lost to disability have gone up, mostly among young and middle-aged women. What does this mean for you? If you live in India and get these headaches, you are far from alone. One survey estimated that about 1 in 4 adults in Delhi and the National Capital Region would benefit from professional headache care. Please note that the rural-versus-urban pattern differs between studies, and we still have fewer studies from east and west India. So treat these as good estimates, not exact counts. Why does this matter for women? In the north India survey, 35.7% of women and 15.1% of men had migraine in the past year. Women had about 3 times the odds of men. If you are a woman who has been told your headaches are "hormones" or "overthinking," please know that the numbers say otherwise. What are the symptoms of migraine? The main symptoms are throbbing headache, nausea or vomiting, and discomfort with light and sound. Doctors describe four stages, though not every person has all four. 1. Warning stage (1 to 2 days before). You may feel moody, crave certain foods, yawn a lot, or have a stiff neck. Many people only realise later that their body was giving hints. 2. Aura (only in some people). This lasts up to an hour. You may see zig-zag lines or flashing lights, lose part of your vision, or feel tingling or weakness on one side. Doctors think aura is caused by a slow wave of electrical activity moving across the brain's surface. 3. The attack. Throbbing or pulsing pain, often on one side, with nausea, vomiting, and sensitivity to light, sound or smell. Untreated, it lasts 4 to 72 hours. 4. Recovery. You may feel tired and foggy for up to a day. Think of it as a "migraine hangover." What causes migraine? Nobody knows the exact cause, but genes and an over-sensitive pain system in the brain are the main reasons. The brainstem and a big facial nerve called the trigeminal nerve are involved. Chemicals such as serotonin and CGRP also play a part. An old belief was that migraine happens because blood vessels in the head widen. Newer research says this is only a side effect, not the root cause. What triggers a migraine? A trigger is something that can set off an attack in a person who already has migraine. Triggers differ from person to person, so your list may not look like your friend's. Common ones are: Hormone changes around periods, pregnancy or menopause Too little (or too much) sleep Skipped or late meals Stress, and the "let-down" after stress Weather changes, such as heat or a change in air pressure Strong smells such as perfume, paint or smoke Bright or flickering light and loud noise Too much tea or coffee, alcohol (especially wine), aged cheese and salty processed food What about chocolate? It is often blamed unfairly. A craving for chocolate can be an early sign that an attack has already started. So the chocolate may be a symptom, not the cause. Keep a headache diary before you cut foods out. Why do young adults get migraines? (Late nights, skipped meals and too much coffee) Migraine often starts in the teenage years and is common among young working adults. The triggers above fit a student or early-career routine very well: late nights and then sleeping in, skipping breakfast for an early class or a deadline, several cups of tea or coffee to get through the day, long hours in bright or flickering light, and constant stress. None of these cause migraine on their own, but in a person who already has migraine, they can set off an attack. You do not have to give up your life to manage it. A regular sleep time, a proper meal on time and a bottle of water on your desk make a bigger difference than most people expect. The SEEDS habits below are built for exactly this.
Brain tumor
Overview A brain tumor is a growth of cells in the brain or near it. Brain tumors can happen in or near the brain tissue. Nearby areas where brain tumors can happen include nerves, the pituitary gland, the pineal gland and the membranes that cover the surface of the brain. Brain tumors can begin in the brain. These are called primary brain tumors. Sometimes, cancer spreads to the brain from other parts of the body. These tumors are secondary brain tumors, also called metastatic brain tumors. There are many different types of primary brain tumors. Some brain tumors are not cancer. These are called noncancerous brain tumors or benign brain tumors. Noncancerous brain tumors may grow over time and press on the brain tissue. Other brain tumors are brain cancers, also called malignant brain tumors. Brain cancers may grow quickly. The cancer cells can invade and destroy brain tissue. Brain tumors range in size from very small to very large. Some brain tumors are found when they are very small because they cause symptoms that you notice right away. Other brain tumors grow very large before they're found. Some parts of the brain are less active than others. If a brain tumor starts in a part of the brain that's less active, it might not cause symptoms right away. The brain tumor could become quite large before the tumor is found. Brain cancers and brain tumors are not classified by stage as some types of cancer are. Brain tumors are graded from 1 to 4 based on a classification system of the World Health Organization (WHO). Grade 1 brain tumors are the least aggressive and grow slowly. Grade 4 brain tumors are the most aggressive and grow quickly. Grade 4 tumors are typically more difficult to treat and have lower survival rates than lower grade tumors. Brain tumor treatment options depend on the type of brain tumor you have, as well as its size and location. Common treatments include surgery and radiation therapy. Types There are many types of brain tumors. The type of brain tumor is based on the kind of cells that make up the tumor. Special lab tests on the tumor cells can give information about the cells. Your healthcare team uses this information to figure out the type of brain tumor. Some types of brain tumors usually aren't cancerous. These are called noncancerous brain tumors or benign brain tumors. Some types of brain tumors usually are cancerous. These types are called brain cancers or malignant brain tumors. Some brain tumor types can be either benign or malignant. Benign brain tumors tend to be slow-growing brain tumors. Malignant brain tumors tend to be fast-growing brain tumors. Gliomas and related brain tumors. Gliomas are growths of cells that start in glial cells. The glial cells surround and support nerve cells in the brain tissue. Types of gliomas and related brain tumors include astrocytoma , glioblastoma , oligodendroglioma and ependymoma . Gliomas can be benign, but most are malignant. Glioblastoma is the most common type of malignant brain tumor. Choroid plexus tumors. Choroid plexus tumors start in cells that make the fluid that surrounds the brain and spinal cord. This fluid is called cerebrospinal fluid. Choroid plexus tumors are located in the fluid-filled cavities in the brain, called the ventricles. Choroid plexus tumors can be benign or malignant. Choroid plexus carcinoma is the malignant form of this type of brain tumor. It's more common in children. Embryonal tumors. Embryonal tumors begin in cells that are left over from fetal development. The cells, called embryonal cells, stay in the brain after birth. Embryonal tumors are malignant brain tumors that happen most often in babies and young children. The most common type of embryonal tumor is medulloblastoma . These tumors are usually located in the lower back part of the brain, called the cerebellum. Germ cell tumors. Germ cell tumors start in reproductive cells, called germ cells, that go on to become sperm and egg cells. Germ cells are mostly in the ovaries and testicles. But sometimes they're in other parts of the body, including the brain. When germ cell tumors happen in the brain, they're often located near the pineal gland, which is located in the center of the brain, or the pituitary gland, which is located near the base of the brain. Germ cell tumors are mostly benign. They're more common in children. Pineal tumors. Pineal tumors start in and around the brain's pineal gland. It makes a hormone called melatonin that helps with sleep. Pineal tumors can be benign or malignant. Pineoblastoma is a malignant type of pineal tumor that's most common in children. Meningiomas. Meningiomas are brain tumors that start in the membranes around the brain and spinal cord. Meningiomas are usually benign, but sometimes they can be malignant. Meningiomas are the most common type of benign brain tumor. Nerve tumors. Nerve tumors are growths that happen in and around nerves. The most common type that happens in the head is acoustic neuroma , also called schwannoma. This benign tumor is located on the main nerve that connects the inner ear to the brain. Pituitary tumors. Brain tumors can begin in and around the pituitary gland. Most tumors that happen in and around the pituitary gland are benign. Pituitary tumors happen in the pituitary gland itself. Craniopharyngioma is a type of brain tumor that happens near the pituitary gland. Other brain tumors. Many other types of rare tumors can happen in and around the brain. Tumors can start in the muscles, blood vessels and connective tissue around the brain. Tumors can form in the bones of the skull. Malignant brain tumors can start from the germ-fighting immune system cells in the brain. This type of brain cancer is called primary central nervous system lymphoma. Book Appointment Find Tumor Specilist Doctors Symptoms The signs and symptoms of a brain tumor depend on the brain tumor's size and location. Symptoms also might depend on how fast the brain tumor is growing, which is also called the tumor grade. General signs and symptoms caused by brain tumors may include: Headache or pressure in the head that is worse in the morning. Headaches that happen more often and seem more severe. Headaches that are sometimes described as tension headaches or migraines. Nausea or vomiting. Eye problems, such as blurry vision, seeing double or losing sight on the sides of your vision. Losing feeling or movement in an arm or a leg. Trouble with balance. Speech problems. Feeling very tired. Confusion in everyday matters. Memory problems. Having trouble following simple commands. Personality or behavior changes. Seizures, especially if there is no history of seizures. Hearing problems. Dizziness or a sense that the world is spinning, also called vertigo. Feeling very hungry and gaining weight. Noncancerous brain tumors tend to cause symptoms that develop slowly. Brain tumors that aren't cancer also are called benign brain tumors. They might cause subtle symptoms that you don't notice at first. The symptoms might get worse over months or years. Cancerous brain tumors cause symptoms that get worse quickly. These tumors also are called brain cancers or malignant brain tumors. They cause symptoms that come on suddenly. The symptoms get worse in a matter of days or weeks. Brain tumor headaches Headaches are the most common symptom of brain tumors. Headaches happen in about half of people with brain tumors. Headaches can happen if a growing brain tumor presses on healthy cells around it. A brain tumor also can cause swelling in the brain that increases pressure in the head and leads to a headache. Headache pain caused by brain tumors is often worse when you wake up in the morning. But it can happen at any time. Some people have headaches that wake them from sleep. Brain tumor headaches tend to cause pain that's worse when coughing or straining. People with brain tumors most often report that the headache feels like a tension headache. Some people say the headache feels like a migraine. Brain tumors in the back of the head might cause a headache with neck pain. If the brain tumor happens in the front of the head, the headache might feel like eye pain or sinus pain. Brain tumor symptoms by location The main part of the brain is called the cerebrum. Brain tumors in different parts of the cerebrum might cause different symptoms.
Keep Your Spine Straight: The Simplest Habit for a Healthy Back
Sit upright, stand tall and avoid unnecessary slouching. Back pain has become a common concern among office workers, drivers, students, homemakers and older adults across India. One of the simplest things you can do to support your spine is to maintain good posture — but this doesn't mean making your back rigid or flat. A healthy spine naturally has gentle curves in the neck, upper back and lower back. Correct posture means maintaining these natural curves while keeping your head balanced over your shoulders and your shoulders aligned over your hips. Why Is Good Posture Important for Spine Health? When your body remains poorly aligned for long periods, some muscles work harder while others become weak or tight. This may contribute to: Lower back pain after sitting for a long time Neck pain from mobile or computer use Shoulder and upper-back stiffness Muscle fatigue and spasms Headaches associated with neck strain Worsening discomfort in people with a disc problem Difficulty maintaining one position for long periods Does Poor Posture Cause Back Pain? Poor posture can strain the muscles and soft tissues supporting the spine, but back pain isn't always caused by posture alone. Other possible causes include: Muscle or ligament strain Reduced physical activity Weak core and back muscles A herniated or slipped disc Sciatica Spinal stenosis Age-related disc changes Osteoporosis or spinal fracture Inflammatory conditions Infection or, rarely, a tumour What Is a Slip Disc? " Slip disc " is a commonly used search term in India. The medical terms are usually slipped disc , herniated disc , prolapsed disc or disc herniation . The discs between the spinal bones act as cushions — when part of a disc bulges or herniates, it may irritate or compress a nearby nerve. Possible slip-disc symptoms include: Lower back or neck pain Pain travelling into an arm or leg Numbness or pins and needles Muscle weakness Pain that worsens during coughing, bending or prolonged sitting What Is Sciatica? Sciatica refers to nerve pain that commonly begins in the lower back or buttock and travels down the leg. People often describe sciatica as: Shooting pain in the leg Burning or electric-shock-like pain Tingling or numbness Pain extending below the knee Leg weakness in more significant cases Neck Pain, Cervical Pain and Mobile-Phone Posture Many Indian patients use the terms cervical pain , cervical problem or cervical spondylosis when describing neck pain — age-related wear affecting the discs and joints of the neck. Long periods looking down at a smartphone or laptop can also strain the neck and upper-back muscles. Spine Warning Signs That Need Urgent Medical Attention Go to the nearest emergency department immediately when back pain is accompanied by: New difficulty controlling urine or stool Inability to pass urine normally Numbness around the inner thighs, genitals or buttocks Rapidly increasing weakness in one or both legs Severe back pain after a major accident Sudden paralysis or major loss of sensation
Brain Stroke
A stroke is a medical emergency that occurs when blood supply to the brain is blocked or when a blood vessel bleeds in the brain. When blood flow becomes blocked or reduced, it's known as an ischemic stroke. This prevents brain tissue from getting oxygen and nutrients. Brain cells begin to die in minutes. Another type of stroke is a hemorrhagic stroke. It occurs when a blood vessel in the brain leaks or bursts and causes bleeding in the brain. The blood increases pressure on brain cells and damages them. It's crucial to get medical treatment right away for a stroke. Emergency medical help can reduce brain damage and other stroke complications. Symptoms & Causes It's important to be able to spot the symptoms of a stroke. If you or someone you're with may be having a stroke, try to note the time the symptoms begin. Tell this time to emergency responders. Some treatments are most effective when given soon after a stroke begins. Symptoms of stroke include: Trouble speaking and understanding what others are saying. A person having a stroke may be confused, slur words or may not be able to understand speech. Numbness, weakness or paralysis in the face, arm or leg. This often affects just one side of the body. When trying to raise both arms overhead, one arm may fall. Also, one side of the mouth may droop when trying to smile. Problems seeing in one or both eyes. A stroke can cause blurry or blackened vision in one or both eyes. It also can cause double vision. Headache. A sudden, severe headache may be a symptom of a stroke. Vomiting, dizziness and a change in consciousness may occur with the headache. Trouble walking. Someone having a stroke may stumble or lose balance or coordination. When to see a doctor Seek medical attention right away if you notice any symptoms of a stroke, even if they seem to come and go or if they go away completely. Think F.A.S.T. and do the following: Face. Ask the person to smile. Does one side of the face droop? Arms. Ask the person to raise both arms. Does one arm drift downward? Or is one arm not able to rise? Speech. Ask the person to repeat a simple phrase. Is the person's speech slurred or different from usual? Time. If you see any of these signs, call 911 or emergency medical help right away. It's essential to call 911 or your local emergency number right away. Don't wait to see if symptoms stop. Every minute counts. The longer a stroke is not treated, the greater the chance of brain damage and disability. If you're with someone you think is having a stroke, watch the person carefully while waiting for emergency assistance.
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