If I could give away a dollar for every time someone had seen me for a headache, I’d have started a small foundation. Around 13 percent of Americans experience migraines, with 30 to 70 percent of the population experiencing tension type headaches. Some studies have found it to be the fourth leading cause of emergency room visits. All of this amounts to a lot of people having headaches every year. So, is this something humans have always suffered with? Or is it an affliction of the modern world?
Headaches have been reported since ancient times, with evidence of treatment dating back as early as 7,000BC. Burr holes, or small holes that were intentionally drilled through the brain have been found in the skulls of mummies from Ancient Egypt, which are believed to be close to 6,000 years old.
Scientists believe that these holes may have been early “neurosurgical” procedures to alleviate head pain, release fluid, and attempt to anatomically study the brain. Mythological texts have reported detailed accounts of headaches in Ancient Egypt, Rome, and Greece. So, all those heroes we read about? They likely suffered from headaches too. There are textbook descriptions of migraines and other types of headaches dating back to first century Rome.
It’s only been in the last 400 to 500 years that we incorporated the knowledge passed down from these times and started to study headaches in a more scientific and rigorous fashion. Edward Liveing was the first person to publish a major treatise about migraines in 1873, which pointed to an overactive central nervous system as their cause. Shortly after, Sir William Gowers, considered a founder of modern neurology, was one of the first to categorize headache treatments as either preventive or abortive. Fast forward to the 1930s, where Harold Wolffe was the first to study headaches in a modern laboratory, finding that the cause of headache could be traced back to vascular dilation.
In this day and age we are able to classify headaches into a structure that helps us to target treatment better. We can utilize medications in ways that shorten or reduce headaches, and we have the ability to see tissues and structural anatomy with imagine such as CT and MRI scans in ways we have not in the past. Yet, we seemingly are experiencing more headaches than ever before, and actually have less answers about the root cause of these debilitating symptoms.
There have been many proposed mechanisms for the causes of headaches, including genetic predisposition, nerve activation, and muscle tension. But none of these are able to fully explain what occurs that leads to a migraine. And so, we’re left with many theories but no clear answers to the questions. I’d like to use this blog to explore some of these theories and questions, to look carefully on what the science has to say, and even start to consider other ideas.