Migraine & Brain MRI: What a Scan Can (and Can’t) Reveal

Migraine causes pain and discomfort to at least 6 million people in the UK, according to the NHS. Up to 16,500 emergency hospital admissions yearly have also been attributed to migraine attacks. An estimated £150 million per year is spent on treating migraines among citizens between 15 and 69 years old. Women are at higher risk of experiencing migraines. The condition also tends to run in families. How can a common and seemingly ordinary ailment cost so much and cause pain to so many?

The main reason why everyone who goes to their doctor complaining about a throbbing head is not required to undergo an MRI is that the brain scan of a person suffering from migraine attacks look the same as someone who does not have a migraine. Also, imaging scans like MRI can be expensive for the NHS to perform, but private MRI scans are reducing in price and most are covered by private medical insurance.
During your consultation, expect to answer questions and undergo a physical examination. Your doctor will specifically attempt to establish whether you are experiencing a primary headache or a secondary headache. The difference is that a secondary headache will have underlying causes, such as a tumour, while a primary headache will not. If your doctor suspects an underlying cause or wants to be sure your migraine does not indicate any other more severe condition, you will likely be sent for a migraine MRI scan to aid further investigation and inform diagnosis.

In a 2017 study published in the journal, Neurology, the researchers found that the brain scan of migraine sufferers showed a decrease in grey matter and white matter fibre volume. The findings suggest that migraines may either cause irreversible damages to the brain or that observed structural damages among migraine sufferers are congenital. On the other hand, the American Migraine Foundation explains that permanent structural damage that affect the brain’s neurological and cognitive functions should not be typically expected among migraine sufferers.

Headaches, no matter how severe or chronic, do not always require an MRI scan. However, when you experience headaches that are sudden, unusual, or cause you to worry, you should book an appointment with your doctor. MRI for migraine headaches is not typically recommended for everyone who experiences migraines. Rather, MRI is only recommended when a migraine has been ruled out and that there are other compelling reasons for a physician to suspect possibly more serious underlying causes. In these cases, a more thorough examination using MRI scanning will be necessary to investigate the following:

Sudden onset of a very bad headache, most especially if it persists over several days
Headache that is accompanied by seizure
Presence of fever
History of involvement in an accident or head injury
speech, numbness, and general weakness on one side of the body

Yes. A landmark study published in Neurology concluded that migraines can cause lesions, particularly in the brain’s white matter.
Another well-acclaimed study published in the journal, Cephalalgia in 2011 found that migraine attacks do not only cause brain lesions but also iron depositions. In addition, the researchers reported a correlation between increased risk of developing lesions and the frequency of migraines. Similarly, the longer a person has experienced migraine attacks, the higher the risk is of developing brain lesions.

Untreated migraines will inevitably worsen. Without proper interventions, such as rest, and support of pain medications, a migraine can go easily from moderate to severe, affect or shift to other parts of the head, or keep going for several days as it causes more pain and discomfort.
Over time, untreated migraine leads to lesions. In turn, lesions can cause structural damage to the brain. Migraine MRI lesions can then lead to brain atrophy. That means migraines can cause irreversible damage to certain neurons which, eventually, can lead to mental health conditions, including dementia and memory loss.