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Wednesday, August 10, 2011

That Which Must Be Endured

For those who are not familiar with how migraines work (it turned out this group included my parents), a little synopsis plus a quick lesson in brain anatomy may be helpful in understanding why bumping my head in a household accident has had such a profound impact on my headaches.

Migraines are considered a neurovascular disorder. While the chemical mechanisms that cause migraines are still poorly understood, a migraine can roughly be summarized as a headache caused by brain chemistry changes in response to triggers that lead to dilation, constriction, and inflammation of the blood vessels lining the brain. Whatever the cause, what is most relevant to my current situation is that the migraine takes place in the menigines, or layers of membrane that cover the brain.

While my brain itself received a superficial injury at most from my collision with the handrail, there was, undoubtably, some damage to the dura matter. In other words, I received a considerable hit to an already constantly inflamed area. Even in the cases of mild head injuries, such as mine, nerve fibers may be damaged and sometimes deteriorate and cerebral circulation can be slowed or abnormal for months or years afterward. Migraines and other headaches can occur in patients who were previously headache-free, and there is plenty of documentation of exacerbation of existing migraines following mild head injuries. The question remains as to how long-term the increased severity of my symptoms may be and to that there is no clear answer. I expect to be better than I am now (and I have improved, if only marginally, as the initial swelling and bruising that likely occurred has gone down), but there is no question that it is worrisome to cause nerve and circulation damage to a brain that is already suffering from a neurovascular disorder as well as a more generalized nervous hyper-excitability. With my brain existing in a perpetual state of sensory overload from innocuous input, I will not be surprised if it remains sensitive to the effects of genuine damage for a long time to come.

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