Migraines Overview

Migraine Diagnosis

A trip through an MRI machine is a good way for doctors to see exactly what's going on inside of your skull.
A trip through an MRI machine is a good way for doctors to see exactly what's going on inside of your skull.
©iStockphoto/Dr. Heinz Linke

Migraines can be difficult to diagnose because the symptoms are often extreme and can resemble many other serious conditions, including stroke, heart attack, brain tumors and meningitis. Most migraine conditions are diagnosed after taking an extensive family history, considering your list of symptoms and ruling out other possible conditions.

While there are no definitive tests for migraines, a doctor may order several tests:

  • MRI (magnetic resonance imaging): This test is used to view the soft tissues of the brain and rule out tumors, dementia and nerve problems. An MRI uses a very strong magnetic field to read the pulses coming from your brain tissues. You'll lie down on a table and be moved into a big tube, which will make thrumming sounds. From this, the doctors can see a detailed, 3-D view of your brain's tissues. Some people who are claustrophobic (afraid of closed spaces) may be uncomfortable with an MRI test. This test takes about 20-45 minutes.
  • CT Scan (computerized tomography): This test is given to rule out blood clots or cancerous tissues. CT Scans are very detailed x-rays. Whereas most x-rays use just one ray, CT scans use lots of rays from different angles to get a 3-D image of your head. Sometimes a doctor will inject a contrast dye into your veins so he or she can see your brain more clearly. The test takes about 15 minutes.
  • Spinal Tap: A spinal tap is used to test for serious brain diseases like bacterial meningitis and encephalitis. It can also check for certain cancers and multiple scleroses. With this test, a doctor will give you something to numb your spine. He or she will then use a long needle to puncture the base of your spine and collect some of the fluid there. The cerebrospinal fluid protects your brain and spine from getting hurt.

Symptoms of migraines can vary from person to person, trigger to trigger, and migraine to migraine. Some people get migraine with an aura, which is a sort of warning system before a migraine starts. Auras can be white or colored lights that flicker at the edge of sight, hallucinations, blind or dark spots at the edge of vision, numbness or tingling (usually in the face or hands). Some people can experience aura symptoms anywhere from 10 minutes to 3 days before migraine pain is actually felt.

Sometimes, people without aura (common migraine) can experience euphoria or other mild symptoms before a migraine sets in.

After the onset of a migraine, in addition to throbbing pain on one side of the skull or sometimes both, most people experience nausea or vomiting, loss of appetite and tiredness. Many people have cognitive problems (problems speaking or hearing, understanding simple written words and problems spelling).